Granuloma inguinale

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Granuloma inguinale
Donovan bodies in a macrophage
Synonyms	Donovanosis, granuloma venereum
Pronounce	N/A
Specialty	N/A
Symptoms	Ulcers on the genitals, inguinal swelling
Complications	Secondary infection, scarring
Onset	Gradual
Duration	Long term without treatment
Types	N/A
Causes	Klebsiella granulomatis
Risks	Sexual contact with an infected person
Diagnosis	Microscopy of tissue samples, PCR
Differential diagnosis	Syphilis, Lymphogranuloma venereum, Chancroid
Prevention	Condom use, safe sex practices
Treatment	Antibiotics such as azithromycin, doxycycline
Medication	Azithromycin, Doxycycline, Ciprofloxacin
Prognosis	N/A
Frequency	Rare in developed countries, more common in tropical and subtropical regions
Deaths	N/A

A chronic bacterial infection affecting the skin and mucous membranes of the genital region

Granuloma inguinale lesion on female genitalia

Granuloma inguinale, also known as donovanosis, is a chronic bacterial infection caused by the organism Klebsiella granulomatis. It primarily affects the skin and mucous membranes of the genital region, leading to ulcerative lesions. The disease is endemic in certain tropical and subtropical regions.

Etiology

Granuloma inguinale is caused by the bacterium Klebsiella granulomatis, formerly known as Calymmatobacterium granulomatis. This organism is a gram-negative, intracellular bacterium that is difficult to culture in the laboratory.

Pathophysiology

The infection is characterized by the formation of granulomatous lesions. The bacteria invade the subcutaneous tissue, leading to a chronic inflammatory response. The lesions are typically painless but can become secondarily infected, leading to pain and discomfort.

Clinical Presentation

Patients with granuloma inguinale typically present with one or more nodular lesions in the genital area. These lesions gradually ulcerate, forming beefy-red, bleeding ulcers. The ulcers may coalesce to form larger areas of tissue destruction.

Diagnosis

Diagnosis of granuloma inguinale is primarily clinical, supported by laboratory findings. The presence of Donovan bodies, which are intracellular inclusions seen in macrophages, is diagnostic. These can be identified using a Wright's or Giemsa stain on tissue smears.

Treatment

The treatment of choice for granuloma inguinale is antibiotic therapy. Azithromycin is commonly used, but other antibiotics such as doxycycline, ciprofloxacin, and erythromycin may also be effective. Treatment should continue until all lesions have healed completely.

Prevention

Preventive measures include practicing safe sex and improving public health awareness in endemic regions. Early diagnosis and treatment of infected individuals can help reduce the spread of the disease.

Complications

If left untreated, granuloma inguinale can lead to significant tissue destruction and scarring. Secondary bacterial infections are common and can complicate the clinical course.

Epidemiology

Granuloma inguinale is most commonly found in tropical and subtropical regions, including parts of India, Papua New Guinea, central Australia, and southern Africa. It is considered a sexually transmitted infection, although non-sexual transmission can occur.

See also

• Sexually transmitted infection
• Klebsiella
• Granuloma