Granuloma inguinale

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
Granuloma Inguinale.JPG

Differential Diagnosis

Sexually transmitted diseases

Evaluation

Workup

  • Microscopy: Donovan bodies
    • Short, pleomorphic rods with bipolar staining
  • Screen for other STDs

Management

Disposition

  • Typically outpatient

See Also

External Links

https://www.cdc.gov/std/tg2015/donovanosis.htm

References