RT Book, Section A1 Dooley-Hash, Suzanne A1 Herrman, Nicholas W.C. A2 Knoop, Kevin J. A2 Stack, Lawrence B. A2 Storrow, Alan B. A2 Thurman, R. Jason SR Print(0) ID 1181041407 T1 Lymphogranuloma Venereum T2 The Atlas of Emergency Medicine, 5e YR 2021 FD 2021 PB McGraw-Hill PP New York, NY SN 9781260134940 LK accessmedicine.mhmedical.com/content.aspx?aid=1181041407 RD 2024/03/28 AB Lymphogranuloma venereum (LGV) is caused by the L1, L2, and L3 serotypes of C trachomatis and primarily affects lymphatic tissue. Primary LGV causes a self-limited painless genital ulceration that may not be noticed by the patient. The presence of pain and/or surrounding erythema, warmth, or tenderness of the area should raise concerns for an alternative diagnosis. Secondary LGV occurs several weeks later and causes painful femoral or inguinal lymphadenopathy. This may occur both above and below the inguinal ligament, causing the “groove sign” suggestive of LGV. Enlarged lymph nodes, or buboes, may spontaneously rupture. Patients with rectal exposure may present with rectal pain, drainage, and tenesmus due to proctocolitis, which may be mistaken for inflammatory bowel disease. Untreated disease can cause sinus tracts to skin, anogenital fibrosis, and strictures.