Lymphogranuloma venereum (LGV) is a sexually transmitted disease caused by a variant of Chlamydia trachomatis different from the variant causing urethritis in men and cervicitis in women. In contrast, it causes genital ulcer in the first stage, while the second stage can be swollen, tender, and enlarged lymph nodes or proctocolitis with rectal discharge. It is endemic in tropical areas of the world. However, it has been increasingly reported in developed countries since 2003. There has been outbreaks reported in Western Europe and North America, primarily in men who have sex with men (MSM) who are also HIV-infected, mostly presenting as proctitis.
LGV is not a reportable disease in Texas. However, the last known case of it in this state was in 2013. Beginning last year, several MSM with HIV have been diagnosed with it here in Austin. Providers here in Austin should be aware of this. LGV can present as proctitis and can get mistaken for Inflammatory Bowel Disease and not get appropriately treated causing complications for the patient such as fistulae, strictures, and infertility; as well as spread of the infection itself as well as of HIV.