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Granuloma inguinale

Contents of this page:

Illustrations

Skin layers
Skin layers

Alternative Names    Return to top

Donovanosis

Definition    Return to top

Granuloma inguinale is a sexually transmitted disease that is rarely seen in the United States.

Causes    Return to top

Granuloma inguinale is caused by the bacteria Calymmatobacterium granulomatis. The disease is commonly found in tropical and subtropical areas such as Southeast India, Guyana, and New Guinea, but it occurs on occasion in the United States, typically in the Southeast. There are approximately 100 cases reported per year in the United States.

The disease spreads mostly through vaginal or anal intercourse. Very rarely, it spreads during oral sex.

Men are affected more than twice as often as women, with most infections occurring in people aged 20-40 years. The disease is seldom seen in children or the elderly.

Symptoms    Return to top

About 50% of infected men and women have lesions in the anal area. Small, beefy-red bumps appear on the genitals or around the anus. The skin gradually wears away, and the bumps turn into raised, beefy-red, velvety nodules called granulation tissue. They are usually painless, but bleed easily if injured.

The disease slowly spreads and destroys genital tissue. Tissue damage may spread to the inguinal folds, the area where the legs meet the torso.

Genitals and surrounding skin has a loss of skin color.

In its early stages, it may be difficult to tell the difference between granuloma inguinale and chancroid. In the later stages, granuloma inguinale may look like advanced genital cancers, lymphogranuloma venereum, and anogenital cutaneous amebiasis.

Exams and Tests    Return to top

Granuloma inguinale should be considered if genital lesions have been present for a long time and have been spreading.

Tests that may be done include:

Laboratory tests, such as those used to detect syphilis, are available only on a research basis for diagnosing granuloma inguinale.

Treatment    Return to top

Antibiotics are used to treat granuloma inguinale. A complete cure requires fairly long treatment. Most treatment courses run 3 weeks or until the lesions have completely healed.

A follow-up examination is essential because the disease can reappear after an apparently successful cure.

Outlook (Prognosis)    Return to top

Treating this disease early decreases the chances of tissue destruction or scarring. Untreated disease results in destruction of the genital tissue.

Possible Complications    Return to top

When to Contact a Medical Professional    Return to top

Call for an appointment with your health care provider if you have had sexual contact with a person who is known to have granuloma inguinale, or if you develop symptoms similar to those listed above.

Prevention    Return to top

Safe sex practices will prevent the spread of granuloma inguinale, as well as other sexually-transmitted diseases.

References    Return to top

Keck JW. Ulcerative Lesions. Clin Fam Pract. 2005 Mar; 7(1); 13-30.

Rackel RE, Bope ET. Granuloma Inguinale. In: Conn's Current Therapy 2005. 57th ed. St. Louis, MO: Saunders; 2005:859.

Update Date: 6/29/2007

Updated by: Cyrus Badshah, M.D., Ph.D., Assistant Professor of Clinical Medicine,College of Physicians and Surgeons, Columbia University; Assistant AttendingPhysician, Department of Medicine, Division of Infectious Diseases & MedicalDirector, Chest (TB)Clinic and Directly Observed Therapy Program, HarlemHospital Center. Review provided by VeriMed Healthcare Network.

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