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Bacterial STI Curable

Lymphogranuloma Venereum (LGV)

Lymphogranuloma venereum (LGV) is an aggressive form of chlamydia caused by more invasive strains of Chlamydia trachomatis. It can trigger painful rectal inflammation or swollen groin lymph nodes, symptoms easy to mistake for other conditions. It's curable with antibiotics, and a standard chlamydia NAAT taken at the right site detects it. A positive chlamydia result with severe rectal or groin symptoms is worth prompt testing and treatment.

Find lymphogranuloma venereum (LGV) testing near you When can lymphogranuloma venereum (LGV) be detected?
Pathogen
C. trachomatis L1–L3
Invasive serovars
Curable
Yes
With antibiotics
Treatment
21 days doxycycline
Longer than ordinary chlamydia
Test
NAAT at symptomatic site
Rectal, genital

Understanding lymphogranuloma venereum (LGV)

What is lymphogranuloma venereum (LGV)?

LGV (lymphogranuloma venereum) is an aggressive form of chlamydia caused by Chlamydia trachomatis serovars L1, L2, or L3. These strains are different from the serovars behind ordinary genital chlamydia, and they cause much more severe inflammation, invading lymphatic tissue rather than staying confined to the surface of the genital or rectal lining.

Because the invasive serovars behave so differently, LGV can produce dramatic symptoms that ordinary chlamydia rarely does: painful rectal inflammation, swollen and tender lymph nodes, and sometimes pus-filled swellings called buboes. The same bacterium, in a more aggressive form, requires a longer and more deliberate course of treatment.

LGV is reportable and managed under CDC STI treatment guidelines. Diagnosis combines clinical suspicion with laboratory confirmation, since the symptoms overlap with other conditions affecting the rectum and groin. Outbreaks in recent years have clustered among men who have sex with men, frequently in people also living with HIV.

The key takeaway is that LGV is curable. A chlamydia NAAT taken at the symptomatic site, most often the rectum, can detect the infection, and a 21-day antibiotic course clears it. Catching it early prevents the more serious tissue damage that untreated LGV can cause.

Where to get tested

Find lymphogranuloma venereum (LGV) testing near you

Choose your test and enter your city: we'll take you straight to local lymphogranuloma venereum (LGV) testing: nearby clinics and labs, prices, hours and county rates.

Test from home

At-home STD testing in the U.S.

if you'd rather skip the trip, an at-home kit ships to the U.S., you collect the sample privately, and mail it back to a CLIA-certified lab. Results come online in days, with a clinician available if anything is positive. Same labs as a clinic, no waiting room, and you can read how accurate at-home STD tests are before you order.

Want a free option first? The CDC-supported TakeMeHome program mails free at-home HIV self-test kits, and, in many areas, free STI kits, to your door, with no insurance or payment needed. The paid kits below add broader panels and faster turnaround.

  • In-home collection

    Quest Diagnostics

    Quest Diagnostics

    $79 & up

    Panel:
    8-infection panel incl. chlamydia, gonorrhea, HIV, syphilis, hepatitis & herpes: single tests too
    Sample:
    Quest Mobile: a phlebotomist collects your sample at home
    Results:
    1–3 days, online: physician-reviewed
    • In-home sample collection
    • Nationwide Quest lab network
    • Physician-reviewed results
    • FSA/HSA eligible
    Order online Quest Diagnostics review

  • Best range: couples & full panels

    myLAB Box

    myLAB Box

    $79 & up

    Panel:
    Up to 14 infections, incl. HIV, syphilis, chlamydia, gonorrhea, hepatitis & herpes
    Sample:
    Self-collect: swab, urine, finger-prick
    Results:
    2–5 days, online
    • Free phone consult if positive
    • CLIA-certified labs
    • Couples & subscription options
    • Discreet packaging
    Order online myLAB Box review

  • Best for simplicity & support

    LetsGetChecked

    LetsGetChecked

    $89 & up

    Panel:
    5–6 common STIs incl. chlamydia, gonorrhea, HIV, syphilis & trichomoniasis
    Sample:
    Finger-prick + urine/swab
    Results:
    2–5 days, online
    • 24/7 nurse support
    • Prescription for positives
    • CLIA-certified labs
    • Free shipping both ways
    Order online LetsGetChecked review

Every kit uses CLIA-certified labs. At-home testing is for screening; a reactive result should be confirmed and treated by a clinician. Prices and panels shown are illustrative and change often, confirm current details on the provider's site.

Symptoms

What are the symptoms of lymphogranuloma venereum (LGV)?

LGV more often produces noticeable symptoms than ordinary chlamydia because the invasive serovars cause pronounced inflammation. However, presentations vary by the site of infection, and early signs can be subtle or mistaken for other conditions. Because the early signs mimic ordinary proctitis or a swollen gland, a chlamydia NAAT at the symptomatic site is what confirms LGV and starts the longer course it needs.

Rectal infection (proctocolitis)

  • Mucoid or bloody rectal discharge
  • Anal pain
  • Constipation
  • Fever
  • Tenesmus, a constant urge to pass stool

Groin lymph node involvement

  • Tender, usually one-sided swelling of the groin lymph nodes (inguinal or femoral)
  • Progression to buboes, fluctuant or pus-filled swellings
  • More common presentation among heterosexual patients

Proctocolitis is the most common presentation in current outbreaks, particularly among men who have sex with men, often with HIV. Symptoms overlap with other rectal and groin conditions, so testing is essential to confirm the diagnosis.

How testing works

How a lymphogranuloma venereum (LGV) test works

How you test for lymphogranuloma venereum (LGV) depends on the infection. The options below cover what each test looks for, how the sample is collected, and where you can get it: at a lab, a clinic, or at home.

When to test

Test when symptoms appear at the affected site, such as the rectum.

After treatment

Diagnosis is based on clinical suspicion plus a Chlamydia trachomatis NAAT taken at the symptomatic site, with other causes ruled out.

Chlamydia trachomatis NAAT (symptomatic site) Most accurate
Sample
Swab from the symptomatic site (e.g. rectum)
Results
Typically a few days

Used alongside clinical suspicion, with other causes ruled out.

What a lymphogranuloma venereum (LGV) test costs

Where What it costs
Private lab (self-pay)Varies by lab and site of testing; ask your provider or clinic.
Free / sliding-scale clinicMany public STI clinics offer testing at low or no cost.
With insuranceSTI testing is commonly covered; confirm with your plan.

Compare STD testing costs across every option.

Screening guidance

Who should get tested for lymphogranuloma venereum (LGV)?

Testing for lymphogranuloma venereum (LGV) is usually guided by symptoms, a known exposure, or a partner's diagnosis rather than routine screening: so you test when you have a reason to, not on a fixed schedule.

  1. 1

    Men who have sex with men with rectal symptoms

    Recent LGV outbreaks have clustered in this group. Rectal pain, discharge, or bleeding warrants testing.

  2. 2

    People living with HIV

    LGV outbreaks frequently involve HIV co-infection. Anyone with HIV and new rectal or groin symptoms should be evaluated.

  3. 3

    Anyone with a positive rectal chlamydia and severe symptoms

    Severe proctocolitis with a positive chlamydia NAAT raises suspicion for LGV serovars.

  4. 4

    People with tender groin lymph node swelling

    One-sided inguinal or femoral swelling, especially with a recent sexual exposure, should prompt LGV evaluation.

  5. 5

    Sex partners of someone diagnosed with LGV

    Partners should be assessed and treated to stop the infection passing back and forth.

If your result is positive

How is lymphogranuloma venereum (LGV) treated?

LGV is curable with antibiotics. Because the invasive serovars cause deeper tissue inflammation, the recommended course is longer than for ordinary chlamydia.

Treat partners

Sex partners who had contact within the 60 days before symptom onset should be examined, tested, and presumptively treated so the infection is not passed back and forth.

Re-test after treatment

Follow your provider's guidance on follow-up after completing the full course.

Treatment & online care

Prevention

How to prevent lymphogranuloma venereum (LGV)

  • Use condoms

    Condoms reduce the risk of LGV and other STIs during anal, vaginal, and oral sex.

  • Test regularly

    Regular STI testing helps catch infections early, before they cause more severe inflammation.

  • Treat partners

    Treating sex partners prevents the infection from being passed back and forth.

Stats & rates

How common is lymphogranuloma venereum (LGV) in the U.S.?

Where you test and what it costs vary by location, see the by-location links below for lymphogranuloma venereum (LGV) testing where you live. Source: CDC, LGV (STI Treatment Guidelines).

Browse by location

Lymphogranuloma venereum (LGV) testing by state & city

Jump to local lymphogranuloma venereum (LGV) testing, clinics and labs, prices and county rates, in your state or a popular city, or explore another test.

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Keep reading

More on lymphogranuloma venereum (LGV)

All condition guides articles

Living with lymphogranuloma venereum (LGV)

Questions to ask your provider about lymphogranuloma venereum (LGV)

Lymphogranuloma venereum (LGV) is treatable and nothing to be ashamed of. The most useful next step after a positive result (or before a first test) is a direct conversation with a clinician. Here are the questions that matter most:

  • Is my lymphogranuloma venereum (LGV) test result definitive, or do I need a confirmatory test?
  • What treatment options are available to me, and how long until I'm no longer contagious?
  • Should I notify my recent partners, and can your office help me do that confidentially?
  • How long is the doxycycline course for LGV (usually 21 days), and how will we confirm it worked?
  • Are there other STIs I should test for at the same visit?
  • Could this cause lasting rectal or lymphatic scarring, and how do we prevent that?

Good to Know

Lymphogranuloma venereum (LGV) testing FAQs

Common questions about lymphogranuloma venereum (LGV) and lymphogranuloma venereum (LGV) testing, answered.

What is LGV?

LGV (lymphogranuloma venereum) is an aggressive form of chlamydia caused by Chlamydia trachomatis serovars L1, L2, or L3. These strains differ from the serovars behind ordinary genital chlamydia and cause much more severe inflammation.

How is LGV different from regular chlamydia?

Both are caused by Chlamydia trachomatis, but LGV is caused by more invasive serovars (L1, L2, and L3, with L2b behind most current outbreaks) that invade lymphatic tissue and cause much more severe inflammation. It also requires a longer treatment course than ordinary chlamydia.

What are the symptoms of LGV?

The most common presentation is proctocolitis from rectal infection: mucoid or bloody rectal discharge, anal pain, constipation, fever, or tenesmus (a constant urge to pass stool). A second presentation is tender, usually one-sided swelling of the groin lymph nodes, which can progress to pus-filled buboes.

How is LGV transmitted?

LGV is sexually transmitted through anal, vaginal, or oral sex, the same routes as other forms of chlamydia.

How is LGV diagnosed?

Diagnosis is based on clinical suspicion plus a Chlamydia trachomatis NAAT taken at the symptomatic site, such as the rectum, with other causes ruled out.

Is LGV curable?

Yes. LGV is curable with antibiotics. The recommended treatment is doxycycline 100 mg orally twice a day for 21 days, a longer course than ordinary chlamydia.

Who is most at risk for LGV?

Outbreaks have been reported among men who have sex with men, often with HIV. The groin lymph node presentation is the more common picture among heterosexual patients.

Do my partners need treatment?

Yes. Treating partners is part of preventing reinfection so the infection is not passed back and forth. The same prevention steps that apply to other STIs, condoms, regular testing, and treating partners, apply to LGV.

Medically Reviewed · Updated

Reviewed by Dr. Ngozi Adeyemi, MD, MPH · Infectious Disease & Epidemiology

Board-certified in infectious disease with a focus on STI epidemiology and public-health screening programs. Leads testing, diagnosis and the data-driven 'state of STDs' reporting. Our editorial guidelines →

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