Granuloma inguinale: Difference between revisions
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==Background== | ==Background== | ||
* "Donovanosis" | *"Donovanosis" | ||
* ''Klebsiella granulomatis'': Intracellular gram negative rod | *''Klebsiella granulomatis'': Intracellular gram negative rod | ||
* [[Sexually transmitted disease]] | *[[Sexually transmitted disease]] | ||
* Tropical and semitropical (India, Papua New Guinea, Australia, Carribean, Africa) | *Tropical and semitropical (India, Papua New Guinea, Australia, Carribean, Africa) | ||
*Very rare in the United States | |||
==Clinical Features== | ==Clinical Features== | ||
* Genital/perineal ulcer | *Genital/perineal ulcer | ||
** Chronic, painless, progressive | **Chronic, painless, progressive | ||
** Irregular, clean-based, granulomatous, nodular | **Irregular, clean-based, granulomatous, nodular | ||
** Hard, bleeds easily | **Hard, bleeds easily | ||
** "Beefy red" | **"Beefy red" | ||
* Urethral stenosis | * Inguinal lymphadenopathy is generally mild or absent | ||
* Lymphatic obstruction, elephantiasis | *Urethral stenosis | ||
* Hematogenous spread to spleen, lungs, liver, bones, orbits | *Lymphatic obstruction, elephantiasis | ||
*Hematogenous spread to spleen, lungs, liver, bones, orbits | |||
[[File:Granuloma Inguinale.JPG|thumb]] | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
{{STD DDX}} | |||
==Workup== | ==Evaluation== | ||
* Microscopy: Donovan bodies | ===Workup=== | ||
** Short, pleomorphic rods with bipolar staining | *Microscopy: Donovan bodies | ||
* Screen for other [[STDs]] | **Short, pleomorphic rods with bipolar staining | ||
*Screen for other [[STDs]] | |||
==Management== | ==Management== | ||
* [[ | *The duration of treatment is a minimum of three weeks, and should be continued until all lesions have completely healed. | ||
*Recommended: [[Azithromycin]] 1g PO qweek | |||
*Alternative: | |||
**[[Doxycycline]] 100mg PO BID | |||
**[[Ciprofloxacin]] 750mg PO BID | |||
**[[Erythromycin]] base 500mg PO QID | |||
**[[Bactrim DS]] (160mg/800mg) PO BID | |||
==Disposition== | |||
*Typically outpatient | |||
==See Also== | ==See Also== | ||
*[[STDs]] | *[[STDs]] | ||
*[[Ulcerative STDs]] | |||
==External Links== | |||
https://www.cdc.gov/std/tg2015/donovanosis.htm | |||
== | ==References== | ||
<references/> | <references/> | ||
[[Category:ID]] | [[Category:ID]] | ||
[[Category: | [[Category:Tropical Medicine]] | ||
Latest revision as of 19:44, 28 July 2021
Background
- "Donovanosis"
- Klebsiella granulomatis: Intracellular gram negative rod
- Sexually transmitted disease
- Tropical and semitropical (India, Papua New Guinea, Australia, Carribean, Africa)
- Very rare in the United States
Clinical Features
- Genital/perineal ulcer
- Chronic, painless, progressive
- Irregular, clean-based, granulomatous, nodular
- Hard, bleeds easily
- "Beefy red"
- Inguinal lymphadenopathy is generally mild or absent
- Urethral stenosis
- Lymphatic obstruction, elephantiasis
- Hematogenous spread to spleen, lungs, liver, bones, orbits
Differential Diagnosis
Sexually transmitted diseases
- Chancroid
- Chlamydia trachomatis
- Granuloma inguinale
- Hepatitis B
- Herpes Simplex Virus-2
- HIV
- Human papillomavirus
- Lymphogranuloma venereum
- Neisseria gonorrhoeae
- Trichomonas
- Syphilis
Evaluation
Workup
- Microscopy: Donovan bodies
- Short, pleomorphic rods with bipolar staining
- Screen for other STDs
Management
- The duration of treatment is a minimum of three weeks, and should be continued until all lesions have completely healed.
- Recommended: Azithromycin 1g PO qweek
- Alternative:
- Doxycycline 100mg PO BID
- Ciprofloxacin 750mg PO BID
- Erythromycin base 500mg PO QID
- Bactrim DS (160mg/800mg) PO BID
Disposition
- Typically outpatient
See Also
External Links
https://www.cdc.gov/std/tg2015/donovanosis.htm