Lymphogranuloma Venereum Infection

Lymphogranuloma venereum is a sexually transmitted infection (STI) caused by , specifically the L1, L2, and L3 serovars,which differ from those responsible for more common  infections. Among these, L2b is the most common serovar of that is responsible for lymphogranuloma venereum. Lymphogranuloma venereum tends to cause more severe inflammation and more aggressive infections compared to is disorders from serovars A-K, where the resulting disease is typically relatively mild or asymptomatic. Lymphogranuloma venereum is rare in the United States compared to other STIs, such as gonorrhea, syphilis, or the more common but less severe chlamydia infections caused by serovars A-K. However, accurate data on the prevalence and incidence of lymphogranuloma venereum are unavailable due to inadequate evaluations, misdiagnoses, diagnostic difficulties, and limited reporting requirements. In August 2018, the Centers for Disease Control and Prevention (CDC) presented data at the National STD Prevention Conference showing that STIs continue to rise at alarming rates. In 2023, nearly 2.3 million cases of chlamydia, gonorrhea, and syphilis were diagnosed in the United States, surpassing the previous record set in 2016 by more than 300,000 cases.  With the rise in transmission of STIs, rare diseases once considered eradicated have resurfaced. Lymphogranuloma venereum is one such example, although accurate data on its prevalence and incidence are unavailable due to inadequate evaluations, misdiagnoses, diagnostic difficulties, and limited reporting requirements. First described in 1833 by Wallace and later by Durand, Nicolas, and Favre in 1913, the infection was initially considered to be climatic in origin and identified as . It was not until 1912 that Rost concluded that the disease was venereal in origin.  Lymphogranuloma venereum presents with variable clinical manifestations depending on the site of bacterial inoculation. The condition primarily affects the lymphatic system and lymph nodes. Classically, the infection characteristically presented with the development of self-limited genital ulceration and painful inguinal adenopathy or . If left untreated, the disease process was progressive and destructive, with systemic spread leading to several extra-genital manifestations. With the advent of antibiotic therapy, lymphogranuloma venereum had largely disappeared from Western society. However, since 2003, outbreaks of lymphogranuloma venereum have emerged in Western Europe, Australia, and North America, disproportionately affecting men who have sex with men (MSM), and the worldwide incidence is increasing.