Criteria
Centers for Disease Control and Prevention[30]
The diagnosis of LGV is based on the clinical findings in combination with a supportive confirmatory test, such as the identification of Chlamydia trachomatis by nucleic acid amplification test, polymerase chain reaction-based genotyping, or Chlamydia serology (complement fixation titers). The diagnosis is also supported by epidemiologic information and exclusion of other causes of genital ulcers, regional lymphadenopathy, or proctocolitis. Serologic testing alone is not sufficient, but in combination with the appropriate clinical context, a complement fixation titer of greater than 1:64 may also support the diagnosis of LGV.
International Union against Sexually Transmitted Infections[1]
The diagnosis of LGV is confirmed by the detection of genovar-specific Chlamydia trachomatis DNA in specimens obtained from the site of infection (e.g., ulcer material from primary anogenital lesions, anorectal swabs from proctoscopic examination, or bubo aspirates). If modern laboratories are available, testing follows a two-step procedure: nucleic acid amplification test (NAAT) screening for C trachomatis then, if positive, NAAT is used to detect LGV genovar-specific DNA. If molecular diagnostic test facilities are not available, then a presumptive LGV diagnosis can be made using Chlamydia genus-specific serological assays. A high antibody titer (especially IgA anti-major outer membrane protein antibodies) in a patient with a clinical syndrome suggestive of LGV supports the diagnosis.[42] A low titer, however, does not exclude LGV infection, nor does a high titer in a patient without LGV symptomatology confirm LGV.
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