Doxycycline 100 mg orally 2 times/day for 21 days.
The likelihood of LGV infection following an exposure is unknown, but it is considered less infectious than some other STI/STDs.
Lymphogranuloma venereum is more common in people with penises.
The infection has historically been associated with painful inguinal lymphadenopathy (buboes) as its pathognomonic sign; however, in recent years, increasing attention has been given to rectal presentations of lymphogranuloma venereum.
Lymphogranuloma venereum has
not historically been identified in Western countries. However, since 2003—when clinicians identified
a cluster of such infections in the Netherlands—LGV
has become endemic in Canada, the United States (US),
the United Kingdom (UK), and Australia.
What to know about LGV and what to do if you have it.
At present, diagnosis is clinical. MSM with inguinal buboes or hemorrhagic proctitis should be treated as LGV on the basis of those symptoms. Serology can be done but it is not highly specific.
Recent published data from the United Kingdom suggest that a 7-day regimen of doxycycline, versus the currently recommended 21-day course, is effective in treating rectal LGV in most MSM.
LGV is not very common in the United States and is most often seen in individuals who have had unprotected receptive anal sex.
LGV can be difficult to diagnose. Typically, the primary lesion produced by LGV is a small genital or rectal lesion, which can ulcerate at the site of transmission after an incubation period of 3-30 days. These ulcers may remain undetected within the urethra, vagina, or rectum. As with other STDs that cause ulcers, LGV may facilitate transmission and acquisition of HIV.
Lymphogranuloma venereum is common in the tropical and subtropical regions around the world. It is rare in the United States. Lymphogranuloma venereum may occur at any age; however, the highest incidence of LGV is in the sexually active population between 15 and 40 years. Lymphogranuloma venereum probably affects both sexes equally although it is more commonly reported in men because early manifestations of LGV are more apparent in men.
Nearly all LGV infections seen in the UK in recent years have been in the rectum.