Lymphogranuloma Venereum

Background

This is a venereal infection caused by Chlamydia trachomatis. There are three classic stages.

STAGE CHARACTERIZATION

Primary
Small painless papules in the genital area
May also have erosions, ulcers, or herpetiform lesions

Fingers and tounge may be involved

Secondary
(Inguinal Syndrome)
Develops within 2-6 weeks after appearance of primary lesions

Prominent painful lymphadenopathy above and below the inguinal ligament (Groove sign)

Fever, arthralgias, myalgias, anorexia

Tertiary (Destructive) More common in women
Fistulas, proctocolitis, perirectal abscesses, ulcerations, and rectal strictures

SYNONYMS LGV

PATHOGENESIS CHARACTERIZATION

Infection with L1, L2, or, L3 serovars of Chlamydia trachomatis

HISTOLOGICAL TYPES CHARACTERIZATION

General

SKIN
Nonspecific resembling granulation tissue with scattered epithelioid cells

LYMPH NODES

Characteristic stellate abscesses surrounded by epithelioid cells and histiocytes-found in second stage of disease

Later stages may have fibrosis

VARIANTS

SPECIAL STAINS/IMMUNOPEROXIDASE/OTHER CHARACTERIZATION

Direct immunofluorescence (DIF) May be helpful in establishing diagnosis

Int J Dermatol 1976;15:26-33.

Commonly Used Terms

Infectious and Microbiology

Skin

Internet Links

Gross or Clinical Photo

Last Updated 2/1/2001

STAGE	CHARACTERIZATION
Primary	Small painless papules in the genital area May also have erosions, ulcers, or herpetiform lesions Fingers and tounge may be involved
Secondary (Inguinal Syndrome)	Develops within 2-6 weeks after appearance of primary lesions Prominent painful lymphadenopathy above and below the inguinal ligament (Groove sign) Fever, arthralgias, myalgias, anorexia
Tertiary (Destructive)	More common in women Fistulas, proctocolitis, perirectal abscesses, ulcerations, and rectal strictures

PATHOGENESIS	CHARACTERIZATION
Infection with L1, L2, or, L3 serovars of Chlamydia trachomatis

HISTOLOGICAL TYPES	CHARACTERIZATION
General
SKIN	Nonspecific resembling granulation tissue with scattered epithelioid cells
LYMPH NODES	Characteristic stellate abscesses surrounded by epithelioid cells and histiocytes-found in second stage of disease Later stages may have fibrosis
VARIANTS

SPECIAL STAINS/IMMUNOPEROXIDASE/OTHER	CHARACTERIZATION
Direct immunofluorescence (DIF)	May be helpful in establishing diagnosis