infectious diseases
Lymphogranuloma Venereum (LGV)
Symptoms and Signs of LGV
Lymphogranuloma venereum occurs in 3 stages. The1st stagebegins after an incubation period of about 3 days with a small skin lesion at the site of entry. It may cause the overlying skin to break down (ulcerate) but heals so quickly that it may pass unnoticed. The2nd stageusually begins in men after about 2 to 4 weeks, with the inguinal lymph nodes on one or both sides enlarging and forming large, tender, sometimes fluctuant masses or abscesses (buboes). The buboes stick to deeper tissues and cause the overlying skin to become inflamed, sometimes with fever and malaise. In women, backache or pelvic pain is common; the initial lesions may be on the cervix or upper vagina, resulting in enlargement and inflammation of deeper perirectal and pelvic lymph nodes. Multiple draining sinus tracts may develop and discharge pus or blood. In the3rd stage,lesions heal with scarring, but sinus tracts can persist or recur. Persistent inflammation due to untreated infection obstructs the lymphatic vessels, causing swelling and skin sores. People who engage in receptive anal sex may have severe proctitis or proctocolitis with bloody purulent rectal discharge during the 1st stage. In the chronic stages, colitis simulating Crohn Disease may cause tenesmus and strictures in the rectum or pain due to inflamed pelvic lymph nodes. Proctoscopy may detect diffuse inflammation, polyps, and masses or mucopurulent exudate—findings that resemble inflammatory bowel disease. 