Minus Related Pages Granuloma inguinale is a genital ulcerative disease caused by the intracellular gram-negative bacterium Klebsiella granulomatis formerly known as Calymmatobacterium granulomatis. The disease occurs rarely in the United States, although it is endemic in some tropical and developing areas, including India; Papua, New Guinea; the Caribbean; central Australia; and southern Africa Clinically, the disease is commonly characterized as painless, slowly progressive ulcerative lesions on the genitals or perineum without regional lymphadenopathy; subcutaneous granulomas pseudobuboes also might occur. The lesions are highly vascular i. Extragenital infection can occur with extension of infection to the pelvis, or it can disseminate to intra-abdominal organs, bones, or the mouth.
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Causes Donovanosis granuloma inguinale is caused by the bacterium Klebsiella granulomatis. The disease is commonly found in tropical and subtropical areas such as southeast India, Guyana, and New Guinea. There are about cases reported per year in the United States. Most of these cases occur in people who have traveled to or are from places where the disease is common.
The disease spreads mostly through vaginal or anal intercourse. Very rarely, it spreads during oral sex. Most infections occur in people ages 20 to Symptoms Symptoms can occur 1 to 12 weeks after coming in contact with the disease causing bacteria. These may include: Sores in the anal area in about half of the cases. Small, beefy-red bumps appear on the genitals or around the anus. The skin gradually wears away, and the bumps turn into raised, beefy-red, velvety nodules called granulation tissue.
They are often painless, but they bleed easily if injured. The disease slowly spreads and destroys genital tissue. Tissue damage may spread to the groin. The genitals and the skin around them lose skin color. In its early stages, it may be hard to tell the difference between donovanosis and chancroid. In the later stages, donovanosis may look like advanced genital cancers, lymphogranuloma venereum , and anogenital cutaneous amebiasis.
Exams and Tests Culture of tissue sample hard to do and not routinely available Scrapings or biopsy of lesion Laboratory tests, similar to those used to detect syphilis, are available only on a research basis for diagnosing donovanosis.
Treatment Antibiotics are used to treat donovanosis. These may include azithromycin, doxycycline, ciprofloxacin, erythromycin, and trimethoprim-sulfamethoxazole. To cure the condition, long-term treatment is needed. Most treatment courses run 3 weeks or until the sores have completely healed. A follow-up examination is important because the disease can reappear after it seems to be cured. Outlook Prognosis Treating this disease early decreases the chances of tissue damage or scarring.
Untreated disease leads to damage of the genital tissue. Possible Complications Health problems that may result from this disease include: Genital damage and scarring Loss of skin color in genital area Permanent genital swelling due to scarring When to Contact a Medical Professional Call for an appointment with your health care provider if: You have had sexual contact with a person who is known to have donovanosis You develop symptoms of donovanosis You develop an ulcer in the genital area Prevention Avoiding all sexual activity is the only absolute way to prevent a sexually transmitted disease such as donovanosis.
However, safer sex behaviors may reduce your risk. The proper use of condoms, either the male or female type, greatly decreases the risk of catching a sexually transmitted disease.
You need to wear the condom from the beginning to the end of each sexual activity. Genital tract infections: vulva, vagina, cervix, toxic shock syndrome, endometritis, and salpingitis. Comprehensive Gynecology. Philadelphia, PA: Elsevier Saunders; chap Granuloma inguinale Donovanosis. Goldman-Cecil Medicine. Klebsiella granulomatis donovanosis, granuloma inguinale.
In contrast to syphilitic ulcers, inguinal lymphadenopathy is generally mild or absent. Tissue biopsy and Wright-Giemsa stain are used to aid in the diagnosis. The presence of Donovan bodies in the tissue sample confirms donovanosis. Donovan bodies are rod-shaped, oval organisms that can be seen in the cytoplasm of mononuclear phagocytes or histiocytes in tissue samples from patients with granuloma inguinale. The disease is commonly known as donovanosis, after the Donovan bodies seen on microscopy, which are a diagnostic sign.
Granuloma Inguinale (Donovanosis)