Granuloma inguinale: Difference between revisions
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*Lymphatic obstruction, elephantiasis | *Lymphatic obstruction, elephantiasis | ||
*Hematogenous spread to spleen, lungs, liver, bones, orbits | *Hematogenous spread to spleen, lungs, liver, bones, orbits | ||
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==Differential Diagnosis== | ==Differential Diagnosis== | ||
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