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.