Granuloma inguinale (Donovanosis)
Review literature: (CDC Guidelines, 2006) (Roest and van der Meijden, 2001) (Schneede et al, 2003).
Definition
Sexually transmitted disease with Calymmatobacterium granulomatis leading to progressive painless genital ulcers
Epidemiology
Granuloma inguinale occurs mainly in tropical countries.
Etiology
Pathogen of granuloma inguinale is gram-negative and intracellular Calymmatobacterium granulomatis.
Signs and Symptoms
Granuloma inguinale presents with progressive painless genital ulcers without lymphadenopathy. The genital ulcers are destructive and can affect the genital organs, the groin and the perineal region [fig. granuloma inguinale]. The lesions are highly vascular ("beefy red" appearance) and bleed easily on contact.
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fig. Granuloma inguinale (Donovanosis): Figure from Dr. Tabua, Papua, New Guinea. Public Health Image Library, Center for Disease Control and Prevention, USA, www.cdc.gov. |
Diagnosis
The causative organism is difficult to culture. Granuloma inguinale is probable with a biopsy showing dark staining Donovan bodies. An attempt of culture should exclude Chancroid, which is the most important differential diagnosis.
Treatment of Granuloma Inguinale
- Doxycycline 100 mg p.o. 1-0-1 for at least 3 weeks
- or
- Trimethoprim-sulfamethoxazole 800mg/160mg p.o. 1-0-1 for at least 3 weeks
- Alternatives: Ciprofloxacin 750 mg p.o. 1-0-1, Erythromycin 500 mg p.o. 1-1-1-1 or Azithromycin 1 g p.o. once per week for at least 3 weeks.
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References
- Center for Disease Control and Prevention.:
- Sexually transmitted diseases treatment guidelines 2006.
in: MMWR
2006; 55 (No. RR-11): 1–93.
- Roest und van der Meijden 2001 ROEST, R. W. ; MEIJDEN, W. I. van der:
- European guideline for the management of tropical genito-ulcerative
diseases.
In: Int J STD AIDS
12 Suppl 3 (2001), S. 78–83
- Schneede u.a. 2003 SCHNEEDE, P. ; TENKE, P. ; HOFSTETTER, A. G.:
- Sexually transmitted diseases (STDs)-a synoptic overview for
urologists.
In: Eur Urol
44 (2003), Nr. 1, S. 1–7
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Deutsche Version: Granuloma inguinae
Last update:
Dr. med. Dirk Manski (E-Mail)