Table of contents
Lymphogranuloma venereum
What's new
Updated 2019 EADV guidelines for the diagnosis and management of lymphogranuloma venereum.
Guidelines
Key sources
The following summarized guidelines for the evaluation and management of lymphogranuloma venereum are prepared by our editorial team based on guidelines from the European Academy of Dermatology and Venereology (EADV 2019) and the British Association for Sexual Health and HIV (BASHH 2013)....
Show more
Screening and diagnosis
Indications for testing: as per EADV 2019 guidelines, Obtain testing for LGV in the following patients:
HIV-positive MSM or in MSM eligible for HIV pre-exposure prophylaxis
A
patients with other C. trachomatis positive sites - urethra/urine/pharynx - if symptoms persist despite receiving recommended treatment options
B
symptomatic patients with suspected LGV
⁄
contacts of confirmed LGV index cases
⁄
all MSM with a C. trachomatis positive anorectal sample irrespective of symptoms.
⁄
Show 3 more
More topics in this section
Diagnosis
Diagnostic investigations
Initial diagnostic testing: as per BASHH 2013 guidelines, Obtain an NAAT to detect C. trachomatis nucleic acid in urethral, cervical, urine, rectal, and pharyngeal specimens.
⁄
More topics in this section
Specimen selection
Nucleic amplification tests
Serology
Culture
Rectal smear
Testing for other STIs
Assessment of sexual partners
Diagnostic procedures
Medical management
General principles: as per EADV 2019 guidelines, Consider initiating treatment for LGV in MSM with a C. trachomatis positive anorectal test result having severe proctitis, if no LGV diagnostic test is readily available.
C
More topics in this section
First-line therapy
Second-line regimens
Second-line therapy
Alternative regimens
Management of sexual partners
Therapeutic procedures
Surgical interventions
Surgical incision: as per EADV 2019 guidelines, Do not perform surgical incision of buboes due to potential complications such as chronic sinus formation.
D
More topics in this section
Reconstructive genital surgery
Patient education
General counseling: as per EADV 2019 guidelines, Inform patients that:
LGV is a STI that can invade connective tissue and regional lymph nodes, but is curable with antibiotics
if left untreated it can have serious and permanent adverse sequelae
most of these complications are preventable if treatment is initiated at an early stage
in anorectal disease, symptoms should resolve within 1-2 weeks of commencing antibiotic therapy
in inguinal disease, symptoms might persist for many weeks and follow-up visits should be implemented.
B
Show 5 more
Follow-up and surveillance
Follow-up: as per EADV 2019 guidelines, Follow-up all patients with LGV at the end of treatment in order to:
ensure treatment compliance, assess side effects, and ensure resolution of symptoms and signs of infection
check that adequate partner notification has been completed
address any patient concerns
arrange suitable follow-up testing for syphilis, gonorrhea and blood-borne viruses including hepatitis B, C and HIV.
B
Show 2 more