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News
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| What is Lymphogranuloma
venereum (LGV)? LGV (Lymphogranuloma
Venereum) is a sexually transmitted
disease (STD) caused by three
strains of Chlamydia trachomatis.
When infected with these particular
strains, there is development of
genital papule(s) (e.g., raised
surface or bumps) and/or ulcers, and
swelling of the lymph glands in the
genital area. LGV may also produce
rectal ulcers, bleeding, pain, and
discharge, especially among those
who practice receptive anal
intercourse.
Infection can be often
asymptomatic in women and perinatal
transmission can rarely occur.
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Are there cases of LGV in North
America and Europe? There is
worldwide distribution of LGV and in
particular these strains are
prevalent in tropical and
subtropical areas. LGV has been
thought to be rare in industrialized
countries but there have been
outbreaks in the Netherlands, other
European countries and recently in
San Francisco among men who have sex
with men.
Because LGV is rare outside of
lesions can be mistaken for other
ulcerative STDs such as syphilis,
genital herpes, and chancroid, so
true incidents of LGV is unknown.
Complications of untreated LGV may
include enlargement and ulcerations
of the external genitalia and
lymphatic obstruction, which may
lead to elephantiasis of the
genitalia.
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| If LGV is
suspected, what specimens can be
sent to the Lab? There are
limitations in commercially
available tests for the detection of
LGV, the diagnosis if primarily
based on clinical findings and risk
factors.
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| How is LGV treated?
LGV can be effectively treated with
three weeks of antibiotics, if
diagnosed and treated early. Current
guidelines recommend doxycycline
twice daily for 21 days. Other
treatment options include
erythromycin or azithromycin. There
is no vaccine against the bacteria.
All sexual partners of the patient
within 60days of the onset of
symptoms need evaluation and
treatment.
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| What are potential
complications of untreated LGV?
Complications of untreated LGV may
include enlargement and ulcerations
of the external genitalia and
lymphatic obstruction, which may
lead to elephantiasis of the
genitalia.
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Ontario Public Health Laboratory
Specimen Submission Requirements for
Lymphogranuloma Venereum
LGV Diagnostic Testing Reports The infectious agent associated with
Lymphogranuloma venereum (LGV) is
Chlamydia trachomatis, serotypes L-1,
L-2 and L-3. The following information
is to outline preferred specimen types
and provide direction for physicians
submitting clinical specimens to the
Ontario Public Health Laboratories for
diagnosing LGV. |
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Specimen type |
Swab/aspirate of
affected sites, e.g. aspirate of
buboe, swab of purulent discharge,
and rectal swabs |
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Collection kit |
Chlamydia
trachomatis Culture Collection Kit (Starswab™
Multitrans™ media) |
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Transport
requirements |
The sample should be
transported to the nearest OPHL at
2-9C within 48 hours of collection. |
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Testing performed |
Nucleic Acid
Amplification for C. trachomatis
Sequencing of C. trachomatis
isolates |
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Results |
1. Chlamydia
trachomatis NAAT result
2. LGV Sequencing result |
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Specimen type |
Blood, clotted or
serum |
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Collection kit |
BL-S |
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Testing performed |
Microimmunofluorescence, MIF IgG and
IgM |
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Results |
Serological titres
reported with interpretation.
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- Both a swab/aspirate and serum
specimen should be submitted from
patients suspected of having LGV.
- Requests for LGV testing are
forwarded to the National Microbiology
Laboratory in Winnipeg, Manitoba.
- Specimens unsuitable or suboptimal
for the detection of LGV include
commercial NAAT swabs or urines
submitted for Nucleic Acid
Amplification testing.
For further information or to order
collection kits please contact your
nearest Ontario Public Health Laboratory
or the Bacterial STD Laboratory in
Toronto at 416-235-5704.
Emergency Duty Officer: (416)
605-3113
Helpline: 1-800-640-7221 |
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