You are here: Urology Textbook > Penis > Sexually transmitted diseases > Granuloma inguinale

Granuloma inguinale (Donovanosis): Symptoms and Treatment

Definition

Granuloma inguinale is a sexually transmitted disease with Calymmatobacterium granulomatis leading to progressive painless genital ulcers (CDC Guidelines, 2006) (Roest and van der Meijden, 2001) (Schneede et al., 2003).

Epidemiology

Granuloma inguinale occurs mainly in tropical countries.

Etiology

Pathogen of granuloma inguinale is gram-negative and intracellular Calymmatobacterium granulomatis.

Signs and Symptoms of Granuloma Inguinale

Incubation period around 50 days. Granuloma inguinale presents with progressive painless highly vascular genital ulcers without inguinal lymphadenopathy. The genital ulcers are destructive and can affect the genital organs, the groin and the perineal region.

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.

References

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

  Deutsche Version: Granuloma inguinae