Epidemic Lymphogranuloma venereum during epidemics of crack cocaine use and HIV infection in the Bahamas

Sex Transm Dis. 2002 May;29(5):253-9. doi: 10.1097/00007435-200205000-00001.


Background: Since the early 1980s, the Bahamas has experienced sequential epidemics of freebase/crack cocaine use, genital ulcer-inguinal adenopathy disease (GUD), and heterosexual HIV infection.

Goal: To prospectively define the etiology of GUD in patients at the Princess Margaret Hospital during outbreaks of crack cocaine use, GUD, and HIV infection in the Bahamas.

Study design: In Nassau, 47 consecutive patients with GUD underwent serologic testing for syphilis and for infections with HIV, herpes simplex virus type 2 (HSV-2), and Chlamydia trachomatis. Genital ulcer specimens were tested by culture and/or polymerase chain reaction (PCR) assay for Haemophilus ducreyi; by PCR and/or antigen assay for HSV; and by PCR for C trachomatis. Lymph node aspirates were tested by PCR for C trachomatis and H ducreyi.

Results: Twenty patients (43%) had HIV infection; eight had lymphogranuloma venereum (LGV), confirmed by PCR detection of C trachomatis sequences consistent with the L2 serovar; and nine others had possible LGV, on the basis of serum microimmunofluorescent C trachomatis antibody titers > or =256. Inguinal lymphadenopathy or bubo was present in 15 of 17 patients, who thus met the laboratory criteria for definite or possible LGV, and in 7 of 30 who did not meet such laboratory criteria (P < 0.001). Thirteen patients had confirmed genital herpes, seven had confirmed chancroid, and four had probable or possible primary syphilis.

Conclusions: The epidemics in the Bahamas of crack use, heterosexual HIV infection, and GUD apparently included epidemic transmission of LGV.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Bahamas / epidemiology
  • Chlamydia trachomatis / isolation & purification
  • Cocaine-Related Disorders / complications
  • Cocaine-Related Disorders / epidemiology*
  • DNA Primers
  • Disease Outbreaks*
  • Female
  • HIV Infections / complications
  • HIV Infections / epidemiology*
  • HIV-1 / isolation & purification
  • HIV-2
  • Haemophilus ducreyi / isolation & purification
  • Herpesvirus 2, Human / isolation & purification
  • Humans
  • Lymphogranuloma Venereum / complications
  • Lymphogranuloma Venereum / epidemiology*
  • Lymphogranuloma Venereum / microbiology
  • Lymphogranuloma Venereum / virology
  • Male
  • Polymerase Chain Reaction
  • Prospective Studies


  • DNA Primers