In lymphogranuloma venereum (LGV; synonyms: Chlamydia trachomatis (serotype L1-L3); Durand-Nicolas-Favre disease; climatic bubo; LGV; lymphogranuloma inguinale; lymphogranuloma inguinale (venereum); lymphogranulomatosis inguinalis; lymphopathia venerea; Nicolas-Durand-Favre disease; venereal granuloma; ICD-10-GM A55: Lymphogranuloma inguinale (venereum) due to chlamydia) is a sexually transmitted disease that is transmitted by serotypes L1-L3 of the bacterial species Chlamydia trachomatis. They are gram-negative pathogens.
The disease belongs to the sexually transmitted diseases (STD) or STI (sexually transmitted infections).
Furthermore, the disease belongs to the “tropical venereal diseases“. These include the bacterial infections lymphogranuloma venereum (LGV), ulcus molle and granuloma inguinale (GI; synonyms: granuloma venereum, donovanosis). The three diseases have in common that they are primarily associated with ulcers (genital ulcer disease, GUD).
Humans currently represent the only relevant pathogen reservoir.
Occurrence: The infection occurs preferentially in Asia, Africa and South America. And then mainly in people with low social status. In Europe and North America, imported cases of the disease are seen very rarely.In Germany, the infection occurs rarely. It is observed here mainly in direct sexual contacts of homosexual men.
Transmission of the pathogen (route of infection) occurs predominantly through direct skin contact with open lesions in the genital, anal or inguinal areas and thus mainly through unprotected sexual intercourse as well as perinatally (“around birth”).
Human-to-human transmission: Yes.
The incubation period (time from infection to onset of disease) is usually between 7-12 (3-21) days.There may even be months between infection and the first signs of disease if the initial symptom is the appearance of bubones (lat. bubo “bump”).
One can distinguish an acute stage from a chronic stage. The latter occurs when no therapy is given.
Sex ratio: Men are more frequently affected than women.
Frequency peak: The disease occurs predominantly between the 20th and 30th year of life.
Course and prognosis: The disease is often asymptomatic (without symptoms). If symptoms occur, it is a painless vesicle, which then ulcerates (= little painful ulcers/ulcers) localized at the site of contact (primary lesion/primary stage). Primary lesions may involve the urethra/urethra (urethritis/urethritis), the anal region (proctitis/ rectal inflammation) after anal intercourse, the mouth and pharynx (throat) after oral intercourse, and the lymphatics of the scrotum and penis (primary lymphangitis). These symptoms regress after a few weeks, even without therapy. If detected and treated early, the infection heals quickly. If the primary stage was not treated, the infection progresses and leads to swelling of the regional lymph nodes, which is accompanied by pain (secondary stage). After several years, a chronic stage is possible. Here, intestinal stenosis (narrowing of the intestine) or disturbances of lymphatic drainage may then occur. All partners in the last three months of the patient should be identified and tested for LGV. Sexual partners should also be treated.
In Germany, the disease is not reportable according to the Infection Protection Act (IfSG).
