Several serovars of C trachomatis cause lymphogranuloma venereum (LGV). The primary genital infection is transient and seldom recognized. Inguinal adenitis may develop, and at times lead to suppuration. It may be confused with chancroid. Ultimately, the lymphatics of the lower genital tract and perirectal tissues may be involved, with sclerosis and fibrosis, which can cause vulvar elephantiasis and severe rectal stricture. Fistula formation involving the rectum, perineum, and vulva also may evolve.

For treatment during pregnancy, erythromycin, 500 mg four times daily, is given for 21 days (Centers for Disease Control and Prevention, 2002d). Although data regarding efficacy are scarce, some authorities recommend azithromycin given in multiple doses for 3 weeks.