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Donovanosis (granuloma inguinale)
Определение(defination)
• Granuloma inguinale is a bacterial disease caused by Klebsiella granulomatis characterized by ulcerative genital lesions. It is endemic in many less developed regions. It is also known as donovanosis
Возбудитель(pathogen)
• gram-negative pleomorphic bacillus Klebsiella granulomatis
пути заражение(ways of transmission)
• sexually active people
• from one host to another through contact with the open sores.
клинические картина(clinical sign)
• Small, painless nodules appear after about 10–40 days of the contact with the bacteria.
• Later the nodules burst, creating open, fleshy, oozing lesions. The infection spreads, mutilating the infected tissue.
• The infection will continue to destroy the tissue until treated.
• shaft of the penis, the labia, or the perineum. Rarely, the vaginal wall or cervix is the site of the lesion
Figure 2 Hypertrophic donovanosis ulcer with a regular margin.
Figure 1
Typical beefy red donovanosis penile ulcer.
Complete destruction of penis by Donovanosis
дифференциальная диагностика(differential diagnosis)
• Chancroid (early stages)
• Herpes Simplex
• Lymphogranuloma Venereum(late stage)
• Syphilis
Лечение(treatment)
• trimethoprim/sulfamethoxazole or doxycycline. Alternatives include ciprofloxacin, erythromycin, or azithromycin.
• The antibiotic should be given for at least a 3-week course and continued until reepithelialization of the ulcer occurs and any signs of the disease have resolved.
• If the granuloma inguinale ulcers do not respond within the first days of therapy, add an aminoglycoside (eg, gentamicin at 1 mg/kg IV q8h).
• In some countries, tetracycline is no longer recommended, owing to bacterial resistance.
Рецидив(relapse)
• Relapse of granuloma inguinale may occur up to 18 months after treatment.
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