Wednesday, June 27, 2012

Lymphogranuloma Venereum

This week’s theme seems to be “Looking for love in all the wrong places”. LGV is a sexually transmitted disease that is caused by Chlamydia trachomatis, which is related to the causative agent that which causes, among other things, trachoma, an eye infection common in parts of Africa.  The serovariants that cause LGV, however, are distinct from the ocular variants and are transmitted sexually instead of by close contact.  The first signs of LGV are usually a painless ulcer on the external genitalia, followed by painful lymphadenopathy, which often leads to draining abscesses.  These buboes, in combination with the history, are pretty much suggestive of LGV.  While in the early part of the lymphadenopathic stage, you see swelling on both sides of the inguinal ligament, which leads to the clinical picture we see above, which is known as the “Groove Sign”.  While not pathognomonic (patients with lymphoma and  other infections can have a faux Groove Sign) it is highly indicative of LGV, and the Pavlovian response you should always have when faced with such a clinical picture is to immediately utter “LGV” under your breath.

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