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Granuloma inguinale
From WikEM
(Redirected from Granuloma Inguinale)
Contents
Background
- "Donovanosis"
- Klebsiella granulomatis: Intracellular gram negative rod
- Sexually transmitted disease
- Tropical and semitropical (India, Papua New Guinea, Australia, Carribean, Africa)
Clinical Features
- Genital/perineal ulcer
- Chronic, painless, progressive
- Irregular, clean-based, granulomatous, nodular
- Hard, bleeds easily
- "Beefy red"
- 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
- Doxycycline 100mg PO BID x 3 weeks or lesion heals
- Alternative: For 3 week duration or until lesion heals
- Azithromycin 1g PO qweek
- Ciprofloxacin 750mg PO BID
- Erythromycin base 500mg PO QID
- Bactrim DS (160mg/800mg) PO BID
