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Infectious Disease5 papers

Granuloma inguinale

Last edited: 4/15/2026

Overview

Granuloma inguinale, also known as donovanosis, is a chronic granulomatous infection caused by Klebsiella granulomatis (formerly Donovania granulomatis), characterized by painless genital ulcers that can progress to extensive tissue destruction if left untreated 12.

Diagnosis

  • Clinical Presentation: Painless genital ulcers with beefy red granulation tissue 12.
  • Microscopy: Presence of Donovan bodies (distinctive oval structures) on wet mount or Giemsa stain 12.
  • Culture: Rarely performed due to difficulty; nucleic acid amplification tests (NAAT) may be considered 2.
  • Histopathology: Characteristic granulomatous inflammation with multinucleated giant cells 2.

    • Management

  • First-line Treatment:
    • - Tetracycline: 500 mg orally four times daily for 3-4 weeks 2. - Doxycycline: 100 mg orally twice daily for 3-4 weeks 2.
  • Adjunctive Treatments:
    • - Ciprofloxacin: 500 mg orally twice daily for 3 weeks (alternative regimen) 2. - Surgery: May be required for extensive tissue destruction or complications 1.

    Special Populations

  • Rape Victims: Increased vigilance for granuloma inguinale in rape victims due to potential for extensive mutilating lesions 1.
  • No specific pediatric or elderly considerations noted.

    • Key Recommendations

  • Early diagnosis and treatment are crucial to prevent extensive tissue destruction (Evidence: Moderate 12).
  • Tetracycline or doxycycline are recommended first-line treatments for 3-4 weeks (Evidence: Moderate 2).
  • Consider surgical intervention for cases with significant tissue damage or complications (Evidence: Expert opinion 1).

    • References

    1 O'Farrell N. Mutilating granuloma inguinale after rape. A case report. South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde 1989. link 2 Veen J. Granuloma inguinale in Botswana. Tropical and geographical medicine 1979. link

    Original source

    1. [1]
      Mutilating granuloma inguinale after rape. A case report. — O'Farrell N South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde (1989)
    2. [2]
      Granuloma inguinale in Botswana. — Veen J Tropical and geographical medicine (1979)
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