Granuloma Inguinale

GRANULOMA INGUINALE(DONOVANOSIS)

• Granuloma inguinale is a genital ulcerative disease caused by the intracellular gram-negative bacterium Klebsiella granulomatis (formerly known as Calymmatobacterium granulomatis)
• The lesion starts as a small painless papule which then ulcerates into a beefy red granulomatous ulcer with rolled edges that bleeds easily. 
•  Lesions are most commonly seen on prepuce, coronal sulcus, frenum, and glans in men and on labia minora and fourchette in women.
• In donovanosis, heaped-up granulomatous tissue may follow and via subcutaneous extension to inguinal area may form “pseudo-buboes”; however, the absence of true lymphadenopathy is the hallmark of this infection.

Complications:

• Pseudoelephantiasis, phimosis and paraphimosis.

Diagnosis-

• The diagnosis is confirmed by by the presence of Donovan bodies in tissue smears. These are gram-negative intracytoplasmic cysts filled with deeply staining bodies that may have a safety-pin appearance. 

Treatment-

• The current first-line drug is azithromycin.  Alternative regimens include doxycycline, ciprofloxacin, erythromycin base, and trimethoprim-sulfamethoxazole