LYMPHOGRANULOMA VENEREUM
Lymphogranuloma venereum (LGV) is caused by the L serotype of Chlamydia
trachomatis. It is uncommon in the United States. The initial lesion is a painless
ulcer.
A painless vesiculopustular eruption, usually on the vulva, spontaneously heals.
This is replaced within a few weeks by perirectal adenopathy that can lead to
abscesses and fistula formation.
The classic clinical lesion is a double genitocrural fold, the “groove sign.”
Diagnosis. A positive culture of pus aspirated from a lymph node confirms the
diagnosis.
Management. Oral doxycycline or erythromycin for three weeks (CDC-
recommended treatment).