Granuloma inguinale

A chronic bacterial infection affecting the skin and mucous membranes of the genital region

Granuloma Inguinale

Granuloma inguinale lesion on female genitalia

Granuloma inguinale, also known as donovanosis, is a chronic bacterial infection caused by the organism Klebsiella granulomatis. It primarily affects the skin and mucous membranes of the genital region, leading to ulcerative lesions. The disease is endemic in certain tropical and subtropical regions.

Etiology

Granuloma inguinale is caused by the bacterium Klebsiella granulomatis, formerly known as Calymmatobacterium granulomatis. This organism is a gram-negative, intracellular bacterium that is difficult to culture in the laboratory.

Pathophysiology

The infection is characterized by the formation of granulomatous lesions. The bacteria invade the subcutaneous tissue, leading to a chronic inflammatory response. The lesions are typically painless but can become secondarily infected, leading to pain and discomfort.

Clinical Presentation

Patients with granuloma inguinale typically present with one or more nodular lesions in the genital area. These lesions gradually ulcerate, forming beefy-red, bleeding ulcers. The ulcers may coalesce to form larger areas of tissue destruction.

Diagnosis

Diagnosis of granuloma inguinale is primarily clinical, supported by laboratory findings. The presence of Donovan bodies, which are intracellular inclusions seen in macrophages, is diagnostic. These can be identified using a Wright's or Giemsa stain on tissue smears.

Treatment

The treatment of choice for granuloma inguinale is antibiotic therapy. Azithromycin is commonly used, but other antibiotics such as doxycycline, ciprofloxacin, and erythromycin may also be effective. Treatment should continue until all lesions have healed completely.

Prevention

Preventive measures include practicing safe sex and improving public health awareness in endemic regions. Early diagnosis and treatment of infected individuals can help reduce the spread of the disease.

Complications

If left untreated, granuloma inguinale can lead to significant tissue destruction and scarring. Secondary bacterial infections are common and can complicate the clinical course.

Epidemiology

Granuloma inguinale is most commonly found in tropical and subtropical regions, including parts of India, Papua New Guinea, central Australia, and southern Africa. It is considered a sexually transmitted infection, although non-sexual transmission can occur.

Related pages

• Sexually transmitted infection
• Klebsiella
• Granuloma