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- LGV due to Chlamydia trachomatis L1, L2 and L3 serovars.
- All chlamydia, including those serovars causing LGV, are obligate intracellular Gram negative microorganisms but LGV serovars are lymphotrophic. Considered to cause systemic disease rather than superficial mucosal infection.
- LGV is distinct from other chlamydia serovars causing either common genital chlamydial disease or trachoma.
- LGV strains infect macrophages and spread to lymph nodes which is different from other C. trachomatis strains that are usually restricted to the the epithelial cells of the conjunctiva and urogenital mucosa. This tropism likely accounts for the differing clinical features and severity of LGV infection when compared with other strains.
- The L2 serovar (and specifically the L2b strain) is the major cause of LGV outbreaks in the North America and Europe. L2b has been reported in at least 1 female partner of a bisexual male.