Granuloma Inguinale (Donovanosis)
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This is a disease that affects the skin and mucous membranes in the genital region; results in nodular lesions that evolve into ulcers
Causes
- Klebsiella granulomatis
Signs and symptoms
- Genital lesion which becomes ulcerated with offensive discharge
- Pseudoelephantiasis of the genitalia, excruciating pain
Differential diagnosis
- Syphilis
- Chancroid
- Lymphoranuloma venerum
- Squamous cell and basal carcinoma
Complications
- Obstructed labour
- Squamous cell carcinoma
Investigations
- Direct microscopy
Treatment objectives
- Eliminate the causative organism
- Prevent re-infection
- Prevent complications
Non-pharmacological treatment
- Clean ulcer and maintain good hygiene
Pharmacological treatment
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Doxycycline oral 100 mg orally twice a day for at least 14 days and until all lesions have completely healed OR Trimethoprim-sulfamethoxazole oral 160 mg/800 mg tablet two times a day for at least 14 days and until all lesions have completely healed Note: Addition of another antibiotic to these regimens can be considered if improvement is not evident within the first few days of therapy: Gentamicin IV 1 mg/kg IV every 8 hours - especially for HIV patients |
Prevention
- Counselling, compliance, condom use, and contact treatment of sexual contact(s)
Referral
- Refer for specialist care if no improvement