Granuloma Inguinale
| A | Syphilis | |
| B |
Chancroid |
|
| C |
LGV |
|
| D |
Granuloma inguinale |
The hard chancre is seen in:
| A |
Syphilis |
|
| B |
Chancroid |
|
| C |
LGV |
|
| D |
Granuloma inguinale |
The hard chancre /hunterian chancre/primary chancre in syphilis is a single, painless, indurated ulcer.
| A |
LGV |
|
| B |
Calymmatobacterium granulomatis |
|
| C |
Neisseria |
|
| D |
Staph aureus |
Calymmatobacterium granulomatis is a gram-negative rod that causes granuloma inguinale (also known as donovanosis), a sexually transmitted disease characterized by genital ulceration and soft tissue and bone destruction.
The diagnosis is made by visualizing the stained organisms (Donovan bodies) within large macrophages from the lesion.
Tetracycline is the treatment of choice for this disease, which is rare in the United States but endemic in many developing countries.
C. granulomatis is also known as Klebsiella granulomatis.
Ref: Levinson W. (2012). Chapter 27. Minor Bacterial Pathogens. In W. Levinson (Ed), Review of Medical Microbiology & Immunology, 12e.
A 25 year old male presents to the clinic with a lesion on his penis. On examination he was noted to have a beefy red ulcer on the glans which bled when touched. Smear taken from the ulcer showed gram-negative intracytoplasmic cysts filled with deeply staining bodies that had a safety-pin appearance. What is he most likely suffering from?
| A |
Syphilis |
|
| B |
HSV infection |
|
| C |
Chancroid |
|
| D |
Granuloma inguinale |
In donovanosis-
| A |
Pseudolymphadenopathy |
|
| B |
Penicillin is used for treatment |
|
| C |
Painful ulcer |
|
| D |
Suppurative lymphadenopathy |
Ans. is `a’ i.e., Pseudolymphadenopathy
Donovanosis
- Caused by Calymmatobacterium granulomatis.
- Gram-negative
- Encapsulated
- Nonmotile
Intracellular
- It shares many morphologic and serologic characteristic (antigenic) and > 99% homology at the nucleotide level with Klebsiella.
- Clinical manifestations
IP → 1-4 weeks
- Begins as one or more subcutaneous nodules that erode through the skin to produce clean, granulomatous, sharply defined, usually painless lesions.
- The genitalia is involved in 90% of cases.
- Genital swelling, particularly of labia, is common.
- In donovanosis, heaped-up granulomatous tissue may follow and via a subcutaneous extension to the 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 preferred diagnostic method involves demonstration of typical intracellular Donovan bodies within large mononuclear cells visualized in smears prepared from lesions or biopsy specimens.
- The stain used is wright – Giemsa
Treatment:
- Azithromycin (DOC)
- Doxycycline (2nd choice)
- Chloramphenicol
| A | Calymatobacter granulomatis | |
| B |
T. pertenue |
|
| C |
Chlamydia Trachomatis |
|
| D |
H. ducreyi |
A i.e. Calymatobacter granulomatis
Treatment of granuloma inguinale is-
| A |
Tetracycline |
|
| B |
Sulphanomide |
|
| C |
Streptomycin |
|
| D |
Pencillin |
A i.e. Tetracycline
Pseudo bubo is seen in ‑
| A |
Donovanosis |
|
| B |
LGV |
|
| C |
Chancroid |
|
| D |
Leprosy |
Ans. is ‘a’ i.e., Donovanosis
Donovan bodies are seen in:
| A |
Granuloma inguinale |
|
| B |
LGV |
|
| C |
Syphilis |
|
| D |
Herpes genitalia4 |
Ans. is ‘a’ i.e., Granuloma inguinale
