Lymphogranuloma Venereum and Granuloma Inguinale

Less common ulcerating STIs include lymphogranuloma venereum (LGV) and granuloma inguinale (Figure 16-5). LGV causes regional adenopathy and often an ulcer at the point of entry. Rectal LGV may cause a proctocolitis with anal pain, discharge, bleeding, and diarrhea. LGV is caused by Chlamydia trachomatis serotypes and can be detected by testing swabbed material from open lesions or aspirates from lymph nodes with culture, DFA, or nucleic acid detection. Treatment is noted above (Table 16-10). Granuloma inguinale, caused by Klebsiella granulomatis, is rare in the United States and causes progressive ulcerative disease of the genitals.

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