Feb 7, 2007
Hi Dr Bob,
I don't know if you are familiar with this rare std.. Lymphomgranuloma Venereum or LGV. It seems to have similar symptoms of HIV.. I tested negative for HIV out to 6mos and have tested negative for other stds as weel. Can LGV be picked up by the standard chlamydia test being that it is a form of chlamydia?
Response from Dr. Frascino
Yes, I'm familiar with rare STDs, including LGV. (After all, I am the cyber sexpert around here, right?) I'll repost some information from the archives that addresses this topic.
Lymphogranuloma Venereum (LGV)
June 19, 2006
Lymphogranuloma venereum (LGV) is a systemic, sexually transmitted disease (STD) caused by a type of Chlamydia trachomatis (serovars L1, L2, or L3) that rarely occurs in the United States and other industrialized countries. However, The Netherlands (MMWR Oct. 29, 2004) and other European countries have reported increases in LGV proctitis among men who have sex with men (MSM). The MMWR article describes The Netherlands' LGV finding including clinical signs and symptoms along with CDC's 2002 STD Treatment Guidelines for LGV. Using LGV testing technology not commercially available (LGV genotyping), CDC has assisted state and local health departments in identifying patients with LGV in cities across the United States. The majority of patients with LGV proctitis in the U.S. have been HIV-infected MSM. In states that lack laboratory capacity to perform LGV diagnostic testing, specimens may be submitted to CDC's Chlamydia Laboratory for testing. If you are a clinician with patients with symptoms consistent with LGV [mucoid/purulent anal discharge, rectal bleeding, constipation, inguinal/femoral lymphadenopathy (buboes), genital or rectal ulcer or papule, anal spasms, and/or tenesmus], please contact your state or local health departments. If state or local testing for LGV proctitis is unavailable, the state public health laboratory may forward specimens to CDC for testing.
At CDC, specimens will be tested for C. trachomatis and, if positive, will be genotyped for the identification of LGV. Serology will only be performed in conjunction with specimens tested directly for LGV (e.g. rectal swabs).
If you have patients you suspect of having LGV, or have questions about LGV, please contact both your state and local health departments. Thank you in advance for your efforts to assist in the prompt identification and control of LGV in the United States.
If you have additional questions about CDC activities regarding LGV, please contact firstname.lastname@example.org.
LGV (lymphogranuloma venereum) Please answer May 4, 2005
While reading the archive, I came across a post about LGV (lymphogranuloma venereum). The post is located at URL http://www.thebody.com/Forums/AIDS/SafeSex/Current/Q163965.html
titled and dated respectively Experiencing symptoms? Read This! , Posted: Mar 27, 2005.
Briefly, in that post a lady is telling a story about her husband who got lymphogranuloma venereum during an intercourse with a sex worker when the condom broke. She stated that she and her husband had a protected intercourse (using a condom) quote Then had sex with me using a condom, (no breaks) thinking he was being overly cautious protecting me from any possible STD's End Quote.
Now, in spite of that fact She and her husband had a protected sex, she got the lymphogranuloma venereum.
My question is could the lymphogranuloma venereum penetrate the latex unbroken condoms?
Response from Dr. Frascino
Latex condoms are impermeable to particles the size of STD germs, including Lymphogranuloma venereum, a rare type of Chlamydia. That we know from laboratory studies. What we do not know is whether the questioner you quoted used a latex condom properly or not.
Hope that helps.
Experiencing symptoms? Read This! Mar 27, 2005
I just want to share my story so that others who think they might be experiencing ARS symptoms get immediate medical attention because there is a rare STD out there making the rounds that has very similar symptoms to ARS and serious complications if left untreated.
I am a married, white, upper middle class surburban mom who has not had a new sexual partner for more than 20 years. My husband recently traveled to Tashkent Uzbekistan on business. and while drunk, had normal vaginal sex with a female sex worker.(The jerk!) Unfortunately, the condom he used broke and he was exposed. He visited a Dr. four days after exposure and tested negative for all common STD's Then had sex with me using a condom, (no breaks) thinking he was being overly cautious protecting me from any possible STD's. In the mean time, within the first week of exposure he started experiencing a vague sort of pain in his penis and at 4 weeks, he experienced full blown flu like symptoms. Low grade fever, severe headache, general malaize, joint pain and body aches, exhaustion, every single ARS symptom except night sweats. The vague discomfort in his penis spread to the testicles and even into his lower abdomen. Then he experienced a rash on his Chest. He was positively positive that he was experiencing ARS symptoms and was devastated by his stupid drunken mistake. In the meantime, I began experiencing all the same symptoms minus the rash. I was even starting to believe we both might have HIV. But my exposure was with a condom; my doctor didn't think I could possibly have anything.And Dr. Bob, you've always assured people that HIV does not travel through an intact condom! My husband visited many doctors, they would prescribe a week of Doxycycline, then a penicillan shot, then Z-pacs. He was on Cipro for a month! Nothing helped! I went to the gynocologist within two weeks of sex with my husband and tested negative for all STD's. I still was feeling poorly and had a slight swelling in the groin area. The doctor commented on it but said "I'm not worried about that." I went to the doctor 4 times over the next 4 months and they thought I was crazy! They humored me and retested for everything again except for Clamydia thinking it deffinently would have shown up in the first test. Negative on everything. My husband and I were miserable because something was deffinently wrong and getting worse! Finally HIV tests for both of us confirmed we DID NOT have HIV. But nobody knew what was wrong with us. Finally my husband went to a urologist and lo and behold, somebody who could put a name to it! LGV. His urologist had just received an e-mail from the CDC about it making a comeback to the US. If you look on the internet, It implies that it is an STD only for Gay men having anal sex. Well I'm here to tell you, neither my husband or I have EVER had anal sex and we were not affected anally by it but we contracted it nevertheless and when I went back to my doctor and told him to specifically test my titer for Chlamydia, sure enough, it was what I was infected with. My husband and I had been living with LGV and are still fighting it for four months now. All the drugs he originally took lowered his Chlamydia titer but never completely got rid of it. and I guess I was tested too early or maybe they simply should have used the more sensitive test but I just want everyone to know out there that this is a serious, nasty, particularly hard to diagnose and get rid of strain of Chlamydia. My husband and I are on massive amounts of Erythromycin now. The daily dosage is so high that it causes us to vomit and we are still fighting to get rid of it because we did not catch it quickly. My doctor was completely embarrased by not being able to diagnose it and by making me feel like I was a hypocondriac. If your experiencing symptoms, just mention LGV to your doctor. Most Doctors in surburban areas have rarely seen LGV if at all. Especially if you have had contact with anyone who has had sexual contact with someone in Asia, South America or the Caribbean. I hope this long winded message might be able to help someone. Seek medical attention Worried Wells! Don't wait and worry!
Response from Dr. Frascino
Thanks for your post.
LGV (lymphogranuloma venereum) has been relatively uncommon in industrialized nations, aside from some cases reported from the Netherlands and the United Kingdom. However, in February the CDC did report six cases in the United States. Since then, other cases have been popping up, mainly in gay and bisexual men. Among the U.S. cases reported so far, most have also had HIV/AIDS. Symptoms of LGV can include flu-like symptoms and a painful bloody rectal infection. Genital ulcers can also occur as can painful draining lymph nodes in the groin area. If identified early, LGV can be treated fairly easily with antibiotics. Left untreated, it can cause permanent damage to the bowels and disfigurement of the genitals (elephantiasis). LGV is a rare form of chlamydia and can be difficult to definitively diagnose.
I agree it's worth mentioning LGV to your doctor as a possibility, if you have symptoms that are consistent with this STD.
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