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 | *[[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 | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
* Chancroid | *[[Chancroid]] | ||
* Herpes | *[[Herpes simplex]] | ||
* Lymphogranuloma | *[[Lymphogranuloma venereum]] | ||
* Syphilis | *[[Syphilis]] | ||
==Workup== | |||
* Microscopy: Donovan bodies | ==Evaluation== | ||
** Short, pleomorphic rods with bipolar staining | ===Workup=== | ||
* Screen for other | *Microscopy: Donovan bodies | ||
**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. | ||
** Alternative: | *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== | |||
*[[STDs]] | |||
*[[Ulcerative STDs]] | |||
==External Links== | |||
https://www.cdc.gov/std/tg2015/donovanosis.htm | |||
== | ==References== | ||
<references/> | <references/> | ||
[[Category:ID]] | |||
[[Category:Tropical Medicine]] | |||
Revision as of 13:11, 14 March 2018
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
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