Author: Vanessa Ngan, Staff Writer, 2003. Updated June 2014.
Granuloma inguinale is a sexually transmitted infection (STI) caused by the bacteria Calymmatobacterium or Klebsiella granulomatis. It is rare in New Zealand. It is characterised by lesions on the genitals or perianal area that start as raised nodules (granulomas) and then erode to form beefy-red velvety heaped-up ulcers that gradually increase in size.
Granuloma inguinale is also called Donovanosis. Donovan bodies are cellular components that are seen when scrapings from the eg of the lesions are viewed under a microscope.
Sexually active people may be at risk of getting granuloma inguinale. It is most commonly found in tropical or subtropical areas of the world such as Papua New Guinea, central Australia, Southern India, the Caribbean and Guyana. In countries where it is less frequently seen, cases are most probably related to foreign travel.
It possibly occurs more frequently in men than women and the peak incidence is in persons between 20–40 years old.
After contracting the infection it may take from 1 week to 3 months for any signs and symptoms to appear. There are several types of lesions that may occur and symptoms are mild.
Complications such as bleeding, secondary infection and swelling (lymphoedema) may occur. Local lymph nodes may be enlarged and may become abscesses or ulcers as the infection spreads into the overlying skin.
In the early stages it may be difficult to differentiate granuloma inguinale from chancroid. In the later stages, the condition may look like lymphogranuloma venereum. It may also be confused with other conditions, such as penile or vulvar cancer or syphilis.
Images supplied by Dr Shahbaz A. Janjua
The main method of diagnosis is the demonstration of Donovan bodies in a tissue sample taken by crush preparation or biopsy. Other tests such as culture, polymerase chain reaction (PCR) or serology are not routinely available.
Granuloma inguinale is treated with antibiotics. Treatment with antibiotics should be for at least 3 weeks and then continued until the lesions have completely healed.
Sexual activity should not take place until all lesions are completely healed. Follow-up examination is necessary to ensure a complete recovery.
If granuloma inguinale is left untreated or treatment is delayed it may cause widespread destruction of the genitals and leave permanent swelling and scarring. Infection may also spread to other parts of the body and cause secondary problems such as pneumonia or heart failure.
All sexual activity should be refrained from until the lesions have completely healed. As with other sexually transmitted infections, if you think you are infected, stop all sexual contact and see your doctor or sexual health clinic immediately. Safe-sex practices will prevent the spread of granuloma inguinale as well as other sexually transmitted diseases.
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