Warning:

This document is being maintained for historical purposes, but is now out of date. To view current guidelines please visit:

• STD Treatment Guidelines   at http://www.cdc.gov/STD/treatment

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1993 Sexually Transmitted Diseases Treatment Guidelines

09/24/1993

SUGGESTED CITATION
Centers for Disease Control and Prevention. 1993 Sexually
transmitted diseases treatment guidelines. MMWR 1993;42(No. RR-14):
{inclusive page numbers}.

CIO Responsible for this publication:
National Center for Prevention Services,
Division of Sexually Transmitted Diseases and HIV Prevention

Lymphogranuloma Venereum
     
     Lymphogranuloma venereum (LGV), a rare disease in the United
States, is caused by serovars L1, L2, or L3 of C. trachomatis. The
most common clinical manifestation of LGV among heterosexuals is
tender inguinal lymphadenopathy that is most commonly unilateral.
Women and homosexually active men may have proctocolitis or
inflammatory involvement of perirectal or perianal lymphatic
tissues resulting in fistulas and strictures. When patients seek
care, most no longer have the self-limited genital ulcer that
sometimes occurs at the site of inoculation. The diagnosis is
usually made serologically and by exclusion of other causes of
inguinal lymphadenopathy or genital ulcers.

Treatment
     Treatment cures infection and prevents ongoing tissue damage,
although tissue reaction can result in scarring. Buboes may require
aspiration or incision and drainage through intact skin.
Doxycycline is the preferred treatment.

Recommended Regimen -
     Doxycycline 100 mg orally 2 times a day for 21 days.

Alternative Regimens -
     Erythromycin 500 mg orally 4 times a day for 21 days
                           or
     Sulfisoxazole 500 mg orally 4 times a day for 21 days or
     equivalent sulfonamide course.

Follow-Up
     Patients should be followed clinically until signs and
symptoms have resolved.

Management of Sex Partners
     Persons who have had sexual contact with a patient who has LGV
within the 30 days before onset of the patient's symptoms should be
examined, tested for urethral or cervical chlamydial infection, and
treated.

Special Considerations

Pregnancy -
     Pregnant and lactating women should be treated with the
erythromycin regimen.

HIV infection -
     Persons with HIV infection and LGV should be treated following
the regimens previously cited.

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