Lymphogranuloma Venereum (LGV): Symptoms & Treatment (2025)

Lymphogranuloma Venereum (LGV): Symptoms & Treatment

Dr. Leonard Leng of ATA Medical Singapore.
Authored By: Dr. Leonard Leng
Last updated: Jul 25, 2025

What Is Lymphogranuloma Venereum (LGV)?

Lymphogranuloma venereum (LGV) is a sexually transmitted infection (STI) caused by specific strains of the bacterium Chlamydia trachomatis.

Unlike the strains responsible for common chlamydia infections, those associated with LGV often cause more severe symptoms.

The infection typically affects the genital area, rectum, or nearby lymph nodes, and is more frequently diagnosed in men, particularly those living with HIV. If left untreated, LGV can lead to chronic inflammation, tissue damage, and long-term complications involving the genital and rectal regions.

Doctor showing Lymphogranuloma Venereum (LGV) diagnosis on clipboard during STD consultation.

What Causes Lymphogranuloma Venereum (LGV)?

LGV is caused by the L1, L2, or L3 strains of Chlamydia trachomatis, which are transmitted through direct contact with infected bodily fluids during sexual activity.

Transmission typically occurs through:

  • Vaginal, anal, or oral sex with an infected partner.
  • Small tears or breaks in the skin or mucous membranes.
  • Sharing sexual devices that are not properly cleaned or used without barrier protection.

Unlike more common forms of chlamydia, LGV strains are more invasive and tend to affect deeper tissues, including the lymphatic system.

3D illustration of Chlamydia trachomatis bacteria transmitting Lymphogranuloma Venereum (LGV).

Lymphogranuloma Venereum (LGV) Symptoms

LGV symptoms can vary depending on the stage of infection and the site of exposure. The incubation period, which refers to the time between exposure and the onset of symptoms, typically ranges from 3 to 30 days.

The condition usually progresses through 3 distinct stages:

Stage of LGV Symptoms
Primary stage
  • A small, often painless sore or ulcer appears at the site of infection (genital, anal, or oral).
  • The sore may go unnoticed as it typically heals without treatment.
Secondary stage
  • Painful swelling of the lymph nodes, especially in the groin (inguinal lymphadenopathy).
  • Rectal symptoms such as pain, discharge, or bleeding.
  • A persistent feeling of incomplete bowel movement.
  • Systemic symptoms including fever, fatigue, and muscle aches.
Tertiary stage (late complications)
  • Chronic inflammation of the affected tissues.
  • Genital swelling, also referred to as elephantiasis.
  • Rectal strictures, which involve narrowing of the rectum.
  • Formation of abnormal passages (fistulas).

In advanced or untreated cases, these complications can lead to permanent scarring of genital or rectal tissue.

How Is Lymphogranuloma Venereum (LGV) Diagnosed?

LGV is diagnosed through a combination of clinical assessment and laboratory testing.

Confirmation typically involves one or more of the following methods:

  • Clinical examination and medical history review – Assessment of symptoms, sexual practices, and risk factors to guide further testing.
  • Nucleic acid amplification tests (NAATs) – Detect Chlamydia trachomatis in urine, rectal, or genital swabs.
  • Genotyping or molecular tests – If Chlamydia trachomatis is detected, further testing using specialised methods that analyse the bacteria’s genetic material can identify whether the infection is caused by LGV-specific strains (L1 to L3).
  • Serological tests – Blood tests used to detect antibodies, but they are less specific and are generally reserved for settings where more precise testing is unavailable.
Woman receiving swab test for Chlamydia trachomatis to diagnose Lymphogranuloma Venereum (LGV).

Lymphogranuloma Venereum (LGV) Treatment

LGV is a curable infection that is commonly treated with a course of antibiotics that target Chlamydia trachomatis, such as doxycycline.

Alternative antibiotics may be considered in certain situations, such as during pregnancy or when doxycycline is not suitable. It is important to complete the entire course of treatment, even if symptoms resolve early, to ensure the infection is fully cleared.

Follow-up testing and clinical evaluation are often advised to confirm that the infection has been successfully treated.

Lymphogranuloma Venereum (LGV) Testing & Treatment Cost

At ATA Medical, we provide discreet and confidential testing for LGV and other STIs, along with treatment when required. Our prices are as follows:

Test / Treatment Test Type Price*
Consultation From $38.15
Genital Ulcer PCR Testing (7 tests)
Herpes Simplex Virus 1 and 2, Haemophilus Ducreyi (Chancroid), Cytomegalovirus, Lymphogranuloma, Venereum, Treponema Pallidum (Syphilis), Varicella Zoster Virus 		Swab $318
Enhanced Genital Ulcer Testing (18 tests)
HIV, Syphilis (swab + blood test), Hepatitis B, Hepatitis C, Chlamydia, Gonorrhoea, Mycoplasma genitalium, Mycoplasma hominis, Trichomonas, Ureaplasma parvum, Ureaplasma urealyticum, Herpes Simplex Virus 1 and 2, Haemophilus Ducreyi (Chancroid), Cytomegalovirus, Lymphogranuloma, Venereum, Treponema Pallidum (Syphilis), Varicella Zoster Virus 		Blood + Swab $538
Oral Antibiotics From $1.09 per tab
*Prices are NETT and inclusive of GST.

We offer comprehensive screening packages that cover a range of STIs and other sexual health concerns. You may request to see a male or female doctor based on your preference.

To learn more or to book an appointment, please contact us.

How Can You Prevent Lymphogranuloma Venereum (LGV)?

You can reduce your risk of LGV by practising safer sex and undergoing regular STI screening. Commonly recommended prevention strategies include:

  • Using condoms consistently and correctly during vaginal, anal, and oral sex.
  • Avoiding the sharing of sexual devices, or ensuring they are thoroughly cleaned and used with barrier protection.
  • Getting tested regularly if you are sexually active, particularly if you have multiple partners or belong to a higher-risk group.
  • Communicating openly with sexual partners about STI status and testing history.
  • Limiting the number of sexual partners and avoiding anonymous sexual encounters.

How Do I Book a Lymphogranuloma Venereum (LGV) Testing Appointment?

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Frequently Asked Questions (FAQ)

The signs and symptoms of lymphogranuloma venereum (LGV) depend on the stage of infection and site of exposure. Early symptoms may include a small, painless sore that often goes unnoticed. As the infection progresses, symptoms can involve swollen lymph nodes, rectal pain, discharge, bleeding, and systemic signs such as fever and fatigue. In untreated cases, chronic inflammation, strictures, fistulas, and genital swelling may develop.
LGV and chlamydia are both caused by Chlamydia trachomatis, but LGV results from specific strains (L1 to L3) that are more invasive. Unlike typical chlamydia infections, which often affect the mucous membranes of the urethra or cervix, LGV primarily targets the lymphatic system and can lead to more severe symptoms such as lymphadenopathy, rectal inflammation, and long-term complications.
The hallmark of lymphogranuloma venereum is painful swelling of the lymph nodes in the groin, often following a painless genital sore that may go unnoticed. In some cases, especially where the rectum is affected, symptoms such as rectal pain, discharge, and bleeding are more prominent. These features distinguish LGV from other STIs and reflect its tendency to invade lymphatic tissue. If you are experiencing symptoms or such an infection, it is advisable to consult a doctor for proper diagnosis and treatment.
Lymphogranuloma venereum is a curable infection when diagnosed and treated promptly with the appropriate antibiotics. Completing the full course of treatment is essential, even if symptoms resolve early, to prevent complications or recurrence. Follow-up testing may be recommended to ensure that the infection has cleared.
The first stage of LGV typically presents with a small, painless sore or ulcer at the site of infection, such as the genitals, anus, or mouth. This lesion often goes unnoticed because it heals on its own and may not cause discomfort. Despite its subtle presentation, early identification is important to prevent progression. Consulting a doctor can help detect and treat the infection before complications arise.
If LGV is left untreated, it can lead to chronic inflammation and serious complications such as rectal strictures, fistulas, and genital swelling (elephantiasis). These outcomes result from tissue damage caused by prolonged infection and may lead to permanent scarring or impaired function in the genital or rectal regions.
LGV is unlikely to be transmitted through kissing, as it primarily spreads through direct contact with infected secretions during vaginal, anal, or oral sex. Although LGV can affect the mouth or throat in rare cases, casual contact such as kissing is not considered a common transmission route.
LGV is detected through clinical assessment and laboratory tests that confirm Chlamydia trachomatis infection and identify LGV-specific strains. This often involves nucleic acid amplification tests (NAATs) on urine or swab samples, followed by genotyping or molecular tests for LGV confirmation. Serological tests may also support diagnosis by detecting immune response. Consulting a doctor can help determine which tests are appropriate based on symptoms and risk factors.
LGV may begin with a painless sore, but later stages can cause significant pain, particularly due to lymph node swelling or rectal inflammation. The primary stage often goes unnoticed because the initial lesion typically heals on its own without causing discomfort. However, pain may develop as the infection progresses. It is advisable to consult a doctor if you notice any persistent or unusual genital or rectal symptoms.
LGV and chancroid are both sexually transmitted infections that can cause genital ulcers, but they differ in cause, appearance, and progression. LGV is caused by Chlamydia trachomatis and typically begins with a painless sore followed by swelling of the lymph nodes, while chancroid, caused by Haemophilus ducreyi, usually presents with painful ulcers and tender, swollen lymph nodes.
While both LGV and syphilis can cause painless genital sores, they are caused by different bacteria and have distinct clinical progressions. LGV is caused by specific Chlamydia trachomatis strains and often leads to lymph node swelling and rectal symptoms, while syphilis, caused by Treponema pallidum, progresses through stages that may include skin rashes, mucous membrane lesions, neurological symptoms, and organ damage.
The incubation period for LGV typically ranges from 3 to 30 days after exposure, depending on the individual and site of infection. During this period, a small sore may appear at the entry site, often going unnoticed. Recognising symptoms early and seeking medical advice can help prevent complications. Consulting a doctor is recommended if you have had recent exposure or are experiencing related symptoms.