TESTING FOR LYMPHOGRANULOMA VENEREUM
The first two stages of LGV produce symptoms that are similar to the symptoms of many other diseases (including colitis, proctitis, proctocolitis, Crohn’s disease, and ulcerative colitis) as well as other STDs (such as syphilis, herpes, and chancroid). The second stage of LGV can also be confused with tuberculosis and plague, as well as cancers such as Hodgkin’s disease. Swollen lymph nodes may also be mistaken for a hernia in the groin area.
The similarities among these diseases make it essential to perform a blood test for the specific strains of Chlamydia trachomatis that cause LGV. This test looks for antibodies, or the body’s immune response to the infection, and is the method of choice today. In the past, cultures for the bacteria from the swollen lymph nodes were performed; however, the bacteria are difficult to grow in culture and the test is expensive, so it is now rarely performed. Skin tests were also performed up until the mid-1970s, but they too have been discontinued, because they do not distinguish between the types of Chlamydia trachomatis that cause the more common chlamydia infections and the types that cause LGV.
If a person has lymph node swelling in the groin area, he or she should be tested for other, more common, sexually transmitted infections (such as syphilis and HIV infection), as well as nonsexually transmitted causes of such swelling. Because people with LGV in the United States are likely to be infected with other STDs as well, a complete screening for sexually transmitted infections is recommended whenever the diagnosis of LGV is made. Because LGV causes open sores in the genitals, HIV is transmitted more easily to those with LGV.
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