Do I Have LGV (lymphogranuloma Venereum)?

LGV is caused by specific invasive strains (serovars L1–L3) of Chlamydia trachomatis — the same species behind ordinary chlamydia, but these strains burrow into tissue and lymph nodes and cause more aggressive disease. In the U.S. LGV is uncommon and occurs mostly among men who have sex with men, frequently in people living with HIV. It's still curable, but needs a longer course of antibiotics than ordinary chlamydia.

There are two main pictures. The most common now is proctitis after receptive anal sex: anal or rectal pain, mucous or bloody rectal discharge, a constant urge to pass stool (tenesmus), constipation, and sometimes fever or feeling unwell — it can look like inflammatory bowel disease. The classic genital form starts as a small, often painless sore or bump that heals on its own and is easily missed, followed 2–6 weeks later by tender, swollen lymph nodes in the groin on one or both sides (buboes) that may be firm or break down.

It starts with a chlamydia NAAT (nucleic acid test) that comes back positive from the rectum or the genital site, then LGV-specific genotyping to confirm the invasive strain. In practice, a standard positive rectal chlamydia test in someone with proctitis symptoms is the usual route to LGV testing, so mention any rectal pain, discharge or bleeding to your clinician.

Proctitis symptoms typically start about 1–3 weeks after exposure. In the classic genital form, the small painless sore appears first, then tender, swollen groin nodes can follow weeks later. Because the early sore is painless and heals on its own, many people don't notice it and only seek care once the glands swell or rectal symptoms set in.

Yes. LGV is curable with antibiotics — typically doxycycline taken for three weeks, a longer course than ordinary chlamydia. Getting seen and treated matters, because untreated LGV can cause lasting damage and scarring. Recent sexual partners should also be evaluated and treated.