The number of cases of the sexually transmitted infection (STI), Lymphogranuloma venereum, or LGV rose by 15 percent in Europe in 2016, according to newly released data from the European Centre for Disease Prevention and Control (ECDC).

Image/Robert Herriman
Image/Robert Herriman

Also known as Lymphogranuloma inguinale and tropical bubo, Lymphogranuloma venereum (LGV) is a sexually transmitted chlamydial infection caused by three related but distinct types of Chlamydia trachomatis (L-1, L2 and L-3).

These are different than the types that cause non-gonococcal urethritis/cervicitis in men and women respectively.

Officials report 2,043 LGV cases from 13 European countries in 2016, up from 1,780 in 2015.  Three countries–France (596), the Netherlands (245) and the United Kingdom (919) accounted for 86% of all notified cases.

Almost all cases in 2016 were reported among men who have sex with men; among the cases with known HIV status, 78% were HIV-positive.

This bacterium is transmitted primarily through sexual contact (oral, genital or anal) and with any direct contact with open lesions. It is believed to be transmissible via skin to skin contact.

The infection is characterized by small painless papules, nodules or ulcers which may form on the penis or within the urethra in men, and on the vulva, vaginal wall or cervix in women. This lesion frequently may go unnoticed. It may take from 3-30 days before the primary lesion appears.

Lymph nodes in the area near the infection typically swell and the presence of inguinal or femoral buboes may be seen. In women these external node are rarely affected, but proctitis may be the result of swelling of the pelvic nodes extending to the rectum.

For those that practice rectal intercourse, proctitis may be a manifestation of the disease. Rectal ulcers, discharge, pain and bleeding are also common presentations.

Elephantiasis of the genitals in both men and women may occur in cases of untreated LGV.

Like other ulcer forming sexually transmitted infections (STI) like syphilis, chancroid and herpes; LGV increases the chance of getting HIV.

LGV can be treated successfully with antibiotics (doxycycline with azithromycin as an alternative) for all stages of infection including lesions and buboes.

As with other ulcerative STI’s, LGV can still be transmitted even with condom use if infected areas are not covered.