Infectious Disease Book

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Granuloma Inguinale

Aka: Granuloma Inguinale, Calymmatobacterium granulomatis, Klebsiella granulomatis, Donovanosis, Donovan Body, Donovan Bodies
  1. See Also
    1. Sexually Transmitted Disease
    2. Genital Ulcer
  2. Epidemiology
    1. Rarest of the sexually transmited diseases that cause Genital Ulcers
  3. Pathophysiology
    1. Caused by Klebsiella granulomatis (previously known as Calmmatobacterium granulomatis)
  4. Signs
    1. Lymphadenopathy absent (contrast with Lymphogranuloma venereum and Chancroid)
    2. Subcutaneous vascular granulomas may be palpable
      1. Scars on healing
    3. Papule or Genital Ulcer
      1. Persistent, painful, beefy-Red Papules or ulcers onset 2-3 months after exposure
      2. Necrosis or sclerosis may occur
      3. Mutilates surrounding tissue
  5. Labs
    1. Screen for other Sexually Transmitted Infections (esp. HIV Infection)
  6. Diagnosis: Histology
    1. Grows poorly in culture (biopsy instead)
    2. Tissue samples
      1. Roll cotton swab over ulcer bed and then over slide
      2. Ulcer edge sample (Punch Biopsy, curettage)
    3. Stains
      1. Wright stain
      2. Giemsa stain
    4. Biopsy findings suggestive of Granuloma Inguinale
      1. Intracytoplasmic Donovan Bodies
        1. Bipolar staining with safety pin appearance
      2. Calymmatobacterium granulomatis organisms
        1. Rod shaped, encapsulated within Macrophages
  7. Management
    1. Evaluate all sexual partners within prior 60 days
    2. Continue antibiotics until lesions are fully healed (at least 21 days)
    3. Antibiotics (Minimum course: 21 days)
      1. Azithromycin 1 gram orally once weekly
      2. Ciprofloxacin 750 mg orally twice daily
      3. Erythromycin base 500 mg orally four times daily
      4. Doxycycline 100 mg orally twice daily (higher risk of treatment failure)
      5. Trimethoprim-Sulfamethoxazole (Bactrim) DS 160/800 orally twice daily (higher risk of treatment failure)
    4. Refractory cases
      1. Gentamicin 1 mg/kg IV every 8 hours
  8. Complications
    1. Lymphatic obstruction
      1. Risk of elephantiasis
    2. Relapse
      1. May occur at 6-18 months despite successful initial antibiotic treatment
  9. References
    1. (2018) Sanford Guide, accessed on IOS 10/26/2019
    2. (2015) MMWR Morb Mortal Wkly Rep 64(RR3):1-37 [PubMed]
    3. Velho (2008) Braz J Infect Dis. Dec 12(6):521-5 [PubMed]
    4. Roett (2012) Am Fam Physician 85(3): 254-62 [PubMed]

Calymmatobacterium granulomatis (bacteria) (C0006792)

Definition (NCI) A species of facultatively anaerobic, Gram negative, rod shaped bacteria assigned to the phylum Proteobacteria. This species is nonmotile, oxidase negative and is covered by a large capsule. K. granulomatis is pathogenic and the causative agent of the sexually transmitted disease Donovanosis.
Definition (NCI_CDISC) Any bacterial organism that can be assigned to the species Klebsiella granulomatis.
Concepts Bacterium (T007)
MSH D002157
SnomedCT 28169008, 417443008
LNC LP17144-4, MTHU044716
English Donovania granulomatis, Calymmatobacter granulomatis, Calymmatobacterium granulomatis (bacteria), calymmatobacterium granulomatis, donovan bodies, Klebsiella granulomatis (Arago and Vianna 1913) Carter et al. 1999, Calymmatobacterium granulomatis Arago and Vianna 1913 (Approved Lists 1980), Encapsulatus inguinalis, Calymmatobacterium granulomatis (organism), Donovan bodies, KLEBSIELLA GRANULOMATIS, Calymmatobacterium granulomatis, Klebsiella granulomatis, Klebsiella granulomatis (organism)
Portuguese Calymmatobacterium granulomatis
Spanish Klebsiella granulomatis, Calymmatobacterium granulomatis, cuerpos de Donovan, Calymmatobacterium granulomatis (organismo), Klebsiella granulomatis (organismo)
French Calymmatobacterium granulomatis
German Calymmatobacterium granulomatis, Donovania granulomatis
Norwegian Calymmatobacterium granulomatis
Dutch Calymmatobacterium granulomatis
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Granuloma Inguinale (C0018190)

Definition (MSHCZE) Onemocnění vznikající obv. v okolí pohlavních orgánů a vyskytující se v teplých oblastech. Původcem je bakterie Calymmatobacterium granulomatis. U muže bývá postižen glans, u žen bývá postižení rozsáhlejší. Průběh bývá chronický, léze mají charakter uzlíků s pozdějším zvředovatěním, obv. nejsou příliš bolestivé. Onemocnění bez léčby probíhá chronicky a po delší době může způsobit značnou lokální destrukci. Spíše než o vlastní přenos pohlavním stykem se připouští možnost autoinokulace. Léčebně se používají doxycyklin, cotrimoxazol, event. erytromycin nebo fluorochinolony. (cit. Velký lékařský slovník online, 2013 http://lekarske.slovniky.cz/ )
Definition (MSH) Anogenital ulcers caused by Calymmatobacterium granulomatis as distinguished from lymphogranuloma inguinale (see LYMPHOGRANULOMA VENEREUM) caused by CHLAMYDIA TRACHOMATIS. Diagnosis is made by demonstration of typical intracellular Donovan bodies in crushed-tissue smears.
Concepts Disease or Syndrome (T047)
MSH D006100
ICD9 099.2
ICD10 A58
SnomedCT 186947000, 28867007
English Donovanosis, Granuloma Inguinale, Granuloma Venereum, GRANULOMA INGUINALE <DONOVANOSIS>, granuloma inguinale, granuloma inguinale (diagnosis), GRANULOMA INGUINALE DONOVANOSIS, Granuloma Inguinale [Disease/Finding], Calymmatobacterium granulomatis infection, (Granuloma inguinale) or (donovanosis) or (pudendal ulcer) (disorder), (Granuloma inguinale) or (donovanosis) or (pudendal ulcer), Granuloma inguinale, Granuloma venereum, Infection due to Calymmatobacterium granulomatis, Infection due to Donovania granulomatis, Pudendal ulcer, Ulcerating granuloma pudendi, Granuloma Donovani, GI - Granuloma inguinale, Granuloma inguinale (disorder), donovanosis, granuloma; inguinale, granuloma; pudendi, granuloma; venereum, infection; Calymmatobacterium granulomatis, inguinal; granuloma, Calymmatobacterium granulomatis; infection, pudendi; granuloma, venereum; granuloma, Granuloma pudendi, Donovanosis;F, Donovanosis;M
German Calymmattobacterium granulomatis Infektion, Granuloma venereum (inguinale), Donovanosis, Granulom, inguinales, Granuloma inguinale, Granuloma venereum
Italian Infezione da Calymmatobacterium granulomatis, Donovanosi, Granuloma venereo, Granuloma inguinale
Portuguese Infecção por Calymmatobacterium granulomatis, Granuloma inguinal, Donovanose, Granuloma Inguinal, Granuloma Venéreo
Japanese 鼡径肉芽腫, ｿｹｲﾆｸｹﾞｼｭ, ﾆｸｹﾞｼｭｶﾘﾏﾄﾊﾞｸﾃﾘｳﾑｶﾝｾﾝ, 肉芽腫カリマトバクテリウム感染, Donovan症, 肉芽腫-鼠径部, 性病性肉芽腫, 鼠径部肉芽腫, 肉芽腫-性病性
Swedish Granuloma inguinale
Czech granuloma inguinale, Granuloma inguinale, Infekce vyvolaná Calymmatobacterium granulomatis, granuloma venereum
Finnish Lokeronivusajos
Russian GRANULEMA PAKHOVAIA, BOLEZN' VENERICHESKAIA PIATAIA, GRANULEMA TROPICHESKAIA IAZVENNAIA, GRANULEMA VENERICHESKAIA, БОЛЕЗНЬ ВЕНЕРИЧЕСКАЯ ПЯТАЯ, ГРАНУЛЕМА ВЕНЕРИЧЕСКАЯ, ГРАНУЛЕМА ПАХОВАЯ, ГРАНУЛЕМА ТРОПИЧЕСКАЯ ЯЗВЕННАЯ
Korean 샅(서혜)육아종
Dutch Calymmatobacterium granulomatis-infectie, Calymmatobacterium granulomatis; infectie, granuloom; inguinale, granuloom; pudendi, granuloom; venereum, infectie; Calymmatobacterium granulomatis, inguinale; granuloom, pudendi; granuloom, venereum; granuloom, granuloma inguinale, Donovanose, Granuloma inguinale, Granuloma venereum
Spanish Infección por Calymmatobacterium granulomatis, donovanosis, granuloma inguinal (trastorno), granuloma inguinal, granuloma pudendo ulceroso, granuloma venéreo, infección por Calymmatobacterium granulomatis, infección por Donovania granulomatis, úlcera pudenda, Granuloma inguinal, Donovanosis, Granuloma Inguinal, Granuloma Venéreo
French Infection à Calymmatobacterium granulomatis, Donovanose, Granulome inguinal, Granulome vénérien, Granuloma venereum, Granulome ulcéreux des organes génitaux
Polish Ziarniniak pachwinowy, Ziarniniak pachwinowy weneryczny, Donovanosis
Hungarian granuloma inguinale, Calymmattobacterium granulomatis fertőzés
Norwegian Granuloma inguinale, Donovaniasis
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Donovan bodies (procedure) (C2266608)

Concepts Laboratory Procedure (T059)
English Donovan bodies, Donovan bodies (procedure)
Sources
Derived from the NIH UMLS (Unified Medical Language System)


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