Lymphogranuloma venereum has three stages. In its primary stage, the disease is more likely to be detected in men; it may go unnoticed in women. After an incubation period of four to 30 days, a small painless ulcer or blister develops in the genital area.
Second-stage LGV develops between one and six weeks later. In this stage, the infection spreads to the lymphatic system, forming buboes (swellings) in the lymph nodes of the groin area. The buboes often merge, soften, and rupture, forming sinuses and fistulas (hollow passages and ducts) that carry an infectious bloody discharge to the outside of the body. Patients with second-stage LGV may also have fever, nausea, headaches, pains in their joints, skin rashes, and enlargement of the spleen or liver.
Third-stage LGV, which is sometimes called anogenitorectal syndrome, develops in about 25% of patients. In men, this stage is usually seen in homosexuals. Third-stage LGV is marked by rectalpain, constipation, a discharge containing pus or bloody mucus, and the development of strictures (narrowing or tightening of a body passage) in the rectum or vagina.