Lymphogranuloma Venereum (LGV) is caused by C. Tracomatis serovars L1, L2, or L3 . The disease occurs rarely in the United States.  The most common clinical manifestations of LGV among Heterosexuals is tender inguinal and/or femoral lymphadenopathy that is most commonly unilateral.  Women and homosexually active men may have proctocolitis or inflammatory involvement of perirectal or perianal lymphatic tissues resulting in fustulas and strictures.  a self-limited genital ulcer sometimes occurs at the site of inoculation.  However, by the time patients seek care, the ulcer usually has disappeared.  "The diagnosis of LGV is usually made serologically and by exclusion of other causes of inguinal lymphadenopathy or genital ulcers.  Complement fixation titers less than or equal to 1:64 are consistent with the diagnosis of LGV.  The diagnostic utility of serologic methods other than complement fixation is unknown.