infectious diseases
Lymphogranuloma Venereum (LGV)
Diagnosis of LGV
Antibody detection Sometimes nucleic acid amplification testing (NAAT) Lymphogranuloma venereum is suspected in patients who have genital ulcers, swollen inguinal lymph nodes, or proctitis and who live in, have visited, or have sexual contact with people from areas where infection is common. LGV is also suspected in patients with buboes, which may be mistaken for abscesses caused by other bacteria. Diagnosis has usually been made by detecting antibodies to chlamydial endotoxin (complement fixation titers > 1:64 or microimmunofluorescence titers > 1:256) or by genotyping using a polymerase chain reaction–based NAAT. Antibody levels are usually elevated at presentation or shortly thereafter and remain elevated. Direct tests for chlamydial antigens with immunoassays (eg, enzyme-linked immunosorbent assay [ELISA]) or with immunofluorescence using monoclonal antibodies to stain pus or NAATs may be available through reference laboratories (eg, Centers for Disease Control and Prevention in the US). All sex partners should be evaluated. After apparently successful treatment, patients should be followed for 6 months. 