LYMPHOGRANULOMA VENEREUM

also called Lymphogranuloma Inguinale, Climatic Bubo, or Nicolas-favre Disease, infection of lymph channels and lymph nodes by the microorganism Chlamydia trachomatis. Like chlamydia, which is a venereal disease caused by C. trachomatis, lymphogranuloma venereum is acquired in sexual intercourse. The disease produces swollen lymph nodes, ulcerations, enlargement of genital organs, and rectal stricture. It is a relatively common disease, occurring throughout most of the world, especially in tropical and subtropical areas. Incidence of the infection is about the same for both sexes, and all races are affected. It is endemic in the southern United States, particularly among the poor. The primary lesion, usually on the genitalia, appears from 5 to 21 days after infection. The lesion is often so transitory as to escape notice, and the first manifestation of the disease may be a hot, tender swelling of lymph glands (buboes) in the inguinal region (groin), appearing from 10 to 30 days after exposure. In the female the initial symptoms frequently occur on the rectum. Fever, chills, headache, and joint pains may be present. Abscess formation with drainage of pus from the inguinal lymph nodes is usual. Later manifestations of the disease include secondary ulceration and elephantiasis (great enlargement) of the genitalia in both sexes, polypoid growths about the anus, inflammation, ulceration, and stricture of the rectum, and (rarely) arthritis, conjunctivitis, and nervous-system involvement. The course of the disease varies from asymptomatic infection to extreme debilitation with chronic invalidism as the result of chronic late manifestations. Effective treatment is limited. Periodic follow-up blood tests for syphilis are advisable.