| • | AKA Lymphogranuloma inguinale (vs. granuloma inguinale makes it easy to remember) |
| • | mainly a disease of lymphatic tissue that spreads to tissue surrounding lymphatics |
| • | Chlamydia trachomatis: 15 serotypes, only 3 cause LGV L1, L2, L3 |
| • | primary lesion: small painless erosion that heals without scarring (patient will often not notice or remember it; and resolves before nodes enlarge) |
secondary lesion: lymphadenopathy (= main clinical presentation)
| • | 1-4 weeks after primary lesion heals |
| • | unilateral 2/3 of time; painful; 1/3 rupture |
| • | buboes = inflammatory swelling of lymph nodes |
| • | groove sign: enlargement of inguinal nodes above, and femoral nodes below, Poupart’s ligament; 1/5 of patients; pathognomonic |
diagnosis:
| • | culture available but recovery rate <50% |
| • | serologic tests non-specific |
| • | therefore, treat with doxycycline |
summary:
| • | rarely see primary genital ulcer |
| • | presents as lymphadenopathy |
| • | females get rectal strictures (because disease affects internal lymphatic drainage) |
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