Granuloma inguinale: Difference between revisions
| Line 15: | Line 15: | ||
* Hematogenous spread to spleen, lungs, liver, bones, orbits | * Hematogenous spread to spleen, lungs, liver, bones, orbits | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
* Chancroid | * [[Chancroid]] | ||
* Herpes | * [[Herpes simplex]] | ||
* Lymphogranuloma | * [[Lymphogranuloma venereum]] | ||
* Syphilis | * [[Syphilis]] | ||
==Workup== | ==Workup== | ||
* Microscopy: Donovan bodies | * Microscopy: Donovan bodies | ||
Revision as of 04:11, 28 December 2014
Background
- "Donovanosis"
- Klebsiella granulomatis: Intracellular gram negative rod
- Sexually transmitted disease
- Tropical and semitropical (India, Papua New Guinea, Australia, Carribean, Africa)
Clinical Features
- Genital/perineal ulcer
- Chronic, painless, progressive
- Irregular, clean-based, granulomatous, nodular
- Hard, bleeds easily
- "Beefy red"
- Urethral stenosis
- Lymphatic obstruction, elephantiasis
- Hematogenous spread to spleen, lungs, liver, bones, orbits
Differential Diagnosis
Workup
- Microscopy: Donovan bodies
- Short, pleomorphic rods with bipolar staining
- Screen for other STD
Management
- Doxycycline 100mg PO BID x 3 weeks or lesion heals
- Alternative: For 3 week duration or until lesion heals
- Azithromycin 1g PO qweek
- Ciprofloxacin 750mg PO BID
- Erythromycin base 500mg PO QID
- Bactrim DS (160mg/800mg) PO BID
- Alternative: For 3 week duration or until lesion heals
Sources
- Rosen's Emergency Medicine 8th edition. 2013. Chapter: Sexually Transmitted Disease p. 1318.
- Fasoldt, JJ, et al. (2013, Apr 9). Granuloma Inguinale (Donovanosis). eMedicine. Retrieved 12/24/2014 from http://emedicine.medscape.com/article/1052617-overview.