Lymphogranuloma Venereum: Causes, Symptoms, and Treatment
Medically reviewed by Harsha Moole, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Lymphogranuloma Venereum?
An infectious disease doctor, who treats infections, or a primary care doctor can diagnose and treat lymphogranuloma venereum (LGV). LGV is a sexually transmitted infection. Some people also see a gastroenterologist, a doctor who treats the bowel, when the rectum is involved. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is lymphogranuloma venereum?
Lymphogranuloma venereum (LGV) is a sexually transmitted infection (STI). It is a long-term (chronic) infection of the lymphatic system. Certain strains of the bacteria Chlamydia trachomatis cause it. The bacteria spread through sexual contact.
LGV is not caused by the same strain that causes genital chlamydia. The CDC says LGV strains can cause severe inflammation and invasive infection. Other chlamydia strains cause mild infection or none.
Symptoms
Symptoms of LGV can begin a few days to a month after contact with the bacteria. They include:
- A small, painless sore on the male genitals or in the female genital tract.
- Swollen groin lymph nodes on one or both sides.
- Swelling and redness of the skin in the groin area.
- Drainage through the skin from lymph nodes in the groin.
- Swelling of the labia in women.
- Painful bowel movements.
- Blood or pus from the rectum.
Lymph nodes around the rectum may also be affected in people who have anal sex. The sore often heals by the time people seek care. With rectal exposure, the most common form is proctocolitis, which is inflammation of the rectum and colon. It can look like inflammatory bowel disease. Some people with rectal LGV have no symptoms.
LGV can cause long-term problems. These include a fistula, which is an abnormal connection, in the rectal area. Other problems are scarring and narrowing of the rectum, and long-term swelling of the genitals. Rarely, it can cause brain inflammation (encephalitis). These problems can appear many years after the first infection.
Causes and who gets it
LGV spreads by sexual contact. It is more common in Central and South America than in North America. It is more common in men than in women. The main risk factor is being HIV-positive.
How doctors diagnose it
Your provider will examine you and ask about your medical and sexual history. Tell your provider if you had sexual contact with someone who may have had LGV symptoms.
Tests may include a blood test for the bacteria. They may also include a lab test for chlamydia on samples from sores, the throat, the rectum, or lymph nodes. Another test is a lymph node biopsy, where a small tissue sample is checked.
Only special LGV tests can confirm it for sure. The CDC says these tests are not widely available. So doctors often use symptoms, exposure history, a chlamydia lab test (NAAT) at the affected site, and ruling out other causes.
Treatment
LGV is treated with antibiotics, including doxycycline and erythromycin. The CDC recommends a 21-day course of doxycycline. Treatment may start at the first visit, before test results are back, if signs fit LGV. Longer courses may be needed for fistulas, buboes (large swollen lymph nodes), and other severe disease. Buboes may need aspiration (drawing out fluid) or incision and drainage.
The goal is to cure the infection and prevent more tissue damage. Some scarring can still occur. With treatment, the outlook is good, and complete recovery can be expected. In pregnancy, doxycycline might be linked with tooth discoloration, but the risk is not well defined.
People with LGV should be tested for other STIs, especially HIV, gonorrhea, and syphilis. They should be retested for chlamydia about 3 months after treatment. People who had sexual contact with them in the 60 days before symptoms began should be evaluated, examined, and tested.
When to see a doctor
Contact your provider if you have been in contact with someone who may have an STI, including LGV. Contact your provider right away if you develop symptoms of LGV. LGV that is not treated early can lead to chronic colorectal fistulas and strictures (narrowing). Call 911 or go to the emergency room if you have bleeding that will not stop, severe belly pain, trouble breathing, or fainting.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Either kind of doctor can examine you, order tests, and start treatment for an STI. They can also arrange follow-up testing and refer you to an infectious disease specialist.
Common questions
Can lymphogranuloma venereum be cured?
Yes, with treatment the outlook is good, and complete recovery can be expected. LGV is treated with antibiotics. If it is not treated early, it can cause chronic fistulas and strictures (narrowing) in the colon and rectum.
Is lymphogranuloma venereum the same as chlamydia?
No, but they are related. LGV is not caused by the same strain of bacteria that causes genital chlamydia. Both involve the bacteria Chlamydia trachomatis.
How can I lower my risk of LGV?
Not having any sexual activity is the only way to prevent an STI. Safer sex behaviors may lower the risk. Using a condom correctly greatly decreases the risk of catching an STI.
Do my sex partners need to be tested for LGV?
Yes. People who had sexual contact with a person who has LGV in the 60 days before symptoms began should be evaluated, examined, and tested for chlamydia.
Sources
- MedlinePlus - Lymphogranuloma venereum
- Centers for Disease Control and Prevention - Lymphogranuloma Venereum (LGV) - STI Treatment Guidelines
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
