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Granuloma Inguinale
Aka: Granuloma Inguinale, Calymmatobacterium granulomatis, Klebsiella granulomatis, Donovanosis, Donovan Body, Donovan Bodies
- See Also
- Sexually Transmitted Disease
- Genital Ulcer
- Epidemiology
- Rarest of the ulcerative sexually transmited diseases
- Signs
- Lymphadenopathy absent
- Subcutaneous granulomas may be palpable
- Scars on healing
- Papule or ulcer
- Persistent, painful, beefy-Red Papules or ulcers onset 2-3 months after exposure
- Necrosis or sclerosis may occur
- Diagnosis: Histology
- Grows poorly in culture
- Tissue samples
- Roll cotton swab over ulcer bed and then over slide
- Ulcer edge sample (Punch Biopsy, curettage)
- Stains
- Wright stain
- Giemsa stain
- Findings suggestive of Granuloma Inguinale
- Intracytoplasmic Donovan Bodies
- Bipolar staining with safety pin appearance
- Calymmatobacterium granulomatis organisms
- Rod shaped, encapsulated within Macrophages
- Management
- Continue antibiotics until lesions are fully healed (at least 21 days)
- Antibiotics (Minimum course: 21 days)
- Doxycycline 100 mg orally twice daily
- Azithromycin 1 gram orally once weekly
- Ciprofloxacin 750 mg orally twice daily
- Erythromycin base 500 mg orally four times daily
- Trimethoprim-Sulfamethoxazole (Bactrim) DS 160/800 orally twice daily
- Complications
- Lymphatic obstruction
- Risk of elephantiasis
- References
- Velho (2008) Braz J Infect Dis. Dec 12(6):521-5
- Roett (2012) Am Fam Physician 85(3): 254-62