Lymphogranuloma venereum
Quick facts
- Lymphogranuloma venereum (LGV) is a rare sexually transmissible infection (STI) that can be cured with antibiotics.
- In Australia, LGV is usually symptomatic, causing pain, discharge or bleeding from the anus, small ulcers on the genitals which may go unnoticed, and swollen lymph nodes in the groin area.
- Between 2017 and 2021 there were on average less than 25 LGV notifications per year in Queensland. During 2021, there was only 1 notification of LGV (the reduced notifications are likely to be related to COVID-19 impacts on transmission and testing).
Lymphogranuloma venereum (LGV) is an STI caused by the bacteria Chlamydia trachomatis. Some types of this bacteria cause the genital infection chlamydia, which is very common in Australia. Other types of this bacteria cause LGV. Chlamydia and LGV are quite different infections. LGV causes ulcers or sores on the genital area and then invades the lymph glands in the pelvis and groin.
LGV is common in South and Central America, the Caribbean, Southeast Asia and Africa. The infection has also spread to Europe, North America and Australia. In Australia, LGV is rare and occurs mainly in men who have sex with men and people who have travelled to or lived in countries where it is common.
Signs and symptoms
After exposure to the infection, a small, painless ulcer or sore develops which may not be noticeable. This can be on the penis, vagina, vulva, anus, rectum, and, on rare occasions, in the mouth. This ulcer or sore can heal in a few days without treatment, but the infection has not gone away.
Between 2 and 6 weeks after initial infection, the lymph glands in the groin or inside the pelvis will show signs of infection, becoming very swollen and painful. The person may become unwell with fevers, aching muscles and joints, and headaches.
A person with an anal infection may experience pain, discharge, bleeding, constipation and/or inflammation. The infection can spread to tissues around the lymph glands. In the groin, this can cause large sores to break out on the skin. Inside the pelvis, this can affect the vagina, rectum and the bowel.
Testing
Swabs will be taken from the anus, vagina, or any ulcers if present. Swabs can often be self-collected while you are at the clinic or pathology collection centre. If the sample is positive for chlamydia, and the clinician suspects LGV, they will request that the sample is also sent for LGV testing. Testing for LGV is not usually offered as part of a routine sexual health check as it is not a common infection in Australia.
How often you test for STIs depends on your lifestyle and how sexually active you are. For sexually active people under 30 it is recommended to get checked at least once each year, but there are situations where getting tested more regularly is advised. STI testing every 3 months is recommended for sexually active men who have sex with men. If you have been travelling and had sex in countries where LGV or other STIs are more common, you should have a sexual health check when you return.
Treatment
LGV is treated with antibiotics that need to be taken for at least 3 weeks.
To ensure the infection has been cured it is important to take all the tablets and to not have sex (not even sex with a condom) until all treatment is finished. Return to your doctor or clinic for a follow-up test 3 weeks after you finish treatment.
If you have symptomatic LGV, anyone you have had sex with in the past 3 months will need to be tested. This is to make sure they do not have the infection and to prevent you being re-infected. This is particularly important for LGV because it is rare. If you have an asymptomatic LGV infection your sexual partners for the last 6 months should be advised they need to be tested. For more information, including sample conversations, see contact tracing. Services that help with telling partners in a confidential and anonymous way (if desired) are available online:
Transmission
LGV is spread through vaginal, anal or oral sex without a condom, especially if there is damage to the skin or mucous membranes. LGV is mainly diagnosed in men who have sex with men, and amongst men who have anonymous sex with multiple partners. Sexual practices which include fisting, rough sex, or sharing sex toys can increase the risk of LGV. Co-infections with HIV, gonorrhoea, syphilis and hepatitis C are common.
Prevention
Practise safe sex. Use a new condom or dental dam for vaginal, anal or oral sex with each sexual partner or in group sex situations. Using water-based lubricant with condoms will be more pleasurable and reduce the risk of the condom breaking or slipping. Do not share sex toys unless they are washed between partners and covered with a new condom.
You should not have sex with someone who has a visible genital ulcer or sore, or been diagnosed with LGV, until after they have completed treatment. Genital ulcers or sores could also be due to other STIs such as herpes or syphilis. If your sexual partner discovers they have a genital sore or ulcer, you will both need a sexual health check.
Health outcome
If not treated, the infection will persist. LGV causes progressive destruction of lymph glands and tissues near lymph glands. Painful swollen lymph nodes may need to be drained using a needle. Sometimes surgery is required in the later stages of the disease. Infections like LGV that cause ulcers and sores around the genitals also increase the risk of being infected with HIV, or of passing on HIV.
Help and assistance
Get qualified health advice 24/7 for the cost of a local call 13 HEALTH (13 43 25 84).
This page provides general information and is not intended to replace the need to see a health professional or have a sexual health check. For more information on LGV or sexual health please talk to a healthcare provider. A doctor, nurse or health worker can assist with:
- providing appropriate tests, treatment and information about how to prevent STIs
- helping people to ensure that their sexual partners get tested and treated.
Other resources
- Safe sex
- For short animations about common STIs, see Queensland Health's YouTube channel Your Sexual Health.
- For comprehensive information about safe sex, STIs, testing and treatment for young adults, see Stop the Rise of STIs.
- For videos and resources developed with Aboriginal and Torres Strait Islander communities, see Young Deadly Free.
- Translated resources about STIs are available from the Ethnic Communities Council of Queensland.