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• DEFINATION
  
• CAUSES
  
• INCUBATION PERIOD
  
• SYMPTOMS
  
• DIFFERENTIAL DIAGNOSIS
  
• SPECIAL INVESTIGATIONS
  
• TREATMENT

 

DEFINATION:

Lymphogranuloma venerum is an infectious veneral disease of lymphnodes and lymphatics caused by chlamydia trachomatis.

CAUSES:

• The causative organism is chlamydia trachomatis which is gram negative cocco bacillus.

• This is a disease contacted through genital acts.
  
• It is rarely contacted through contaminated exudates.

INCUBATION PERIOD:

About 3 days to 3 weeks

SYMPTOMS

In lymphogranuloma venerum distinctly two syndromes are seen:

• Inguinal syndrome
• Genito-anorectal syndrome.

Inguinal syndrome

• Within few days after sexual contact small vesicles or ulcers are formed on the genitalia which may be unnoticed but more often the first evidence is enlarged lymph nodes.
• These lymphnodes may be enormously enlarged below and above the inguinal ligament forming a groove "called sign of the groove" and ultimately suppurate with discharge of yellow pus.
• Marked scarring and multiple sinuses develop.

• Several constitutional symptoms like

                                                                  a) Fever
                                                                  b) Malaise
                                                                  c) Arthralgia
                                                                  d) Abdominal pain
                                                                  e) Nausea
                                                                  f) Vomitting,   may develop.

• In the course of time the ulcers heal by scarring.

Genito-Anorectal syndrome

• This is commonly seen in females and homosexual males.
  
• There may be perirectal inflammation and discharge of blood mucus and pus through anus.
  
• Afterwards ulcers heal by stricture formation.
  
• There may be lymphoedema of penis,vulva and scrotum and gradually polyploid growth of tissue develops called "Esthiomene"
  

DIFFERENTIAL DIAGNOSIS:

Rectal carcinoma

SPECIAL INVESTIGATIONS:

• Freis intradermal test and complement fixation tests are positive.
• False positive vdrl test may also be seen.
  
• Specific immunofluorescence tests for IgM are more specific in acute cases.
• Causative organisms may be demonstrated by Giemsa stain.
  

TREATMENT:

Treatment involves antibiotics and may involve drainage of the buboes or abscesses by needle aspiration or incision. Further supportive measure may need to be taken: dilatation of the rectal stricture, repair of rectovaginal fistulae, or colostomy for rectal obstruction.

Common antibiotic treatments include: tetracycline,doxycycline (all tetracyclines, including doxycycline, are contraindicated during pregnancy and in children due to effects on bone development and tooth discoloration), and erythromycin.