1
|
Abstract
Donovanosis is a chronic, progressive, and indolent bacterial disease that affects the skin and mucous membranes of the genital and perigenital regions, often associated with sexual transmission, and with low infectivity. The malignant transformation of donovanosis lesions occurs exceptionally, as is usually seen in long-term ulcerations.
Collapse
Affiliation(s)
- Walter Belda Junior
- Department of Dermatology, Faculty of Medicine, Universidade de São Paulo, São Paulo, SP, Brazil.
| |
Collapse
|
2
|
Magalhães BM, Veasey JV, Mayor SAS, Lellis RF. Donovanosis in a child victim of sexual abuse: response to doxycycline treatment. An Bras Dermatol 2018; 93:592-594. [PMID: 30066775 PMCID: PMC6063095 DOI: 10.1590/abd1806-4841.20187948] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Accepted: 03/06/2018] [Indexed: 11/21/2022] Open
Abstract
Donovanosis is a chronic infectious disease caused by the Gram-negative bacteria Klebsiella granulomatis, which mainly affects the skin and mucous membranes of the genital, perigenital, and inguinal regions. Also known as venereal granuloma or granuloma inguinale, it is endemic in tropical and subtropical regions of the globe and often associated with sexual transmission. We report the case of an 11-year-old female victim of chronic sexual abuse, who was diagnosed with donovanosis and presented a good therapeutic response to doxycycline.
Collapse
|
3
|
Narang T, Manhas A, Kumar B. Donovanosis With Bowen Disease. Skinmed 2017; 15:73-75. [PMID: 28270316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
A 45-year-old farmer presented with ulcers and plaques over his scrotum for the past 4 to 5 years. The condition started as a small lesion on the shaft of the penis, which improved with treatment; however, after 2 to 3 months, papulonodular lesions developed on the scrotum, which increased in size and subsequently broke down to form ulcers. He denied drug abuse but had a history of multiple unprotected sexual exposures. He was prescribed oral antibiotics, which improved the lesions, but he failed to take the antibiotics for more than a week. He also used powders, lotions, and salves (exact nature not known), which did not help and sometimes even burned the skin. After stopping the medicine, he developed new lesions that followed a similar course. Examination revealed nontender ulcers on the scrotum with raised, rolled-out margins and pale red, granulation tissue that bled on touch (Figure 1). In addition, there were nodules with a pinkish red granular surface and scaly erythematous plaques on the scrotum. Regional lymph nodes were not enlarged.
Collapse
Affiliation(s)
- Tarun Narang
- Department of Dermatology, Venereology & Leprology, Post Graduate Institute of Medical Education and Research, Chandigarh, India;
| | - Ashwini Manhas
- Department of Microbiology, Gian Sagar Medical College and Hospital, Ram Nagar, Banur, Patiala, India
| | - Bhushan Kumar
- Silver Oaks Multispecialty Hospital, Mohali, Punjab, India
| |
Collapse
|
4
|
Ornelas J, Kiuru M, Konia T, Larsen L. Granuloma inguinale in a 51-year-old man. Dermatol Online J 2016; 22:13030/qt52k0c4hj. [PMID: 27617463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Accepted: 04/18/2016] [Indexed: 06/06/2023] Open
Abstract
Granuloma inguinale, or Donovanosis, is a rare, sexually transmitted ulcerative disease primarily affecting the genital area. In this report, we present a case of a 50-year-old man that was diagnosed with granuloma inguinale after a 2-month history of a penile ulcer. Histological analysis demonstrated the presence of Donovan bodies within macrophages, confirming the diagnosis. He was subsequently treated with trimethoprim/sulfamethoxazole with improvement in the ulcer. This case serves as a reminder to clinicians that although granuloma inguinale is rarely encountered in the US, it should still be suspected in patients with non-healing penile ulcers.
Collapse
|
5
|
Bright A. National Notifiable Diseases Surveillance System surveillance report: Sexually transmissible infections in Aboriginal and Torres Strait Islander people. Commun Dis Intell (2018) 2015; 39:E584-E589. [PMID: 26779731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- Amy Bright
- Office of Health Protection, Australian Government Department of Health, Canberra, Australian Capital Territory
| |
Collapse
|
6
|
Affiliation(s)
- Nadia Ahmed
- Department of Genitourinary Medicine, Mortimer Market Centre, London, UK.
| | - Ashendri Pillay
- Department of Paediatric Infectious Diseases, King Edward VIII Hospital, KwaZulu-Natal, South Africa
| | - Melissa Lawler
- Department of Paediatric Infectious Diseases, King Edward VIII Hospital, KwaZulu-Natal, South Africa
| | - Raziya Bobat
- Department of Paediatrics, University of KwaZulu-Natal, South Africa
| | - Moherndran Archary
- Department of Paediatric Infectious Diseases, King Edward VIII Hospital, KwaZulu-Natal, South Africa
| |
Collapse
|
7
|
Abstract
Sexually transmitted diseases (STDs) are common and they can involve the anus and rectum in both men and women. In this article, the main bacterial and viral STDs that affect the anus and rectum are discussed, including their prevalence, presentation, and treatment.
Collapse
Affiliation(s)
- Molly M Cone
- Department of Colon and Rectal Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | | |
Collapse
|
8
|
Abstract
A 46-year-old man complained of ulcerovegetative lesions in the anogenital region, which he had noted one month prior to presentation. The patient had a history of travel to African countries. Therefore, the ulcerovegetative lesions of the patient were suspected to be granuloma inguinale (GI). Calymmatobacterium granulomatis was not observed in the direct examination of scrapings collected from the base of the ulcerovegetative lesion. Instead, a histological examination revealed cutaneous metastasis of mucinous adenocarcinoma of the rectum. Therefore, a diagnosis of GI was eliminated. As the patient did not report his history of rectal cancer and had travelled to African countries, we had primarily focused on the diagnosis of GI.
Collapse
Affiliation(s)
- Ilknur Balta
- Dermatology Department, Ministry of Health, Etlik Ihtisas Training and Research Hospital, Turkey.
| | | | | | | | | | | | | |
Collapse
|
9
|
Filho RJDLC, de Carvalho Portela N, Neto AMP, Teixeira Henderson MNR, Pinheiro RF. Nontuberculous mycobacterium genital infection mimicking donovanosis in a patient with hairy cell leukemia. Leuk Res 2011; 35:e44-5. [PMID: 21295854 DOI: 10.1016/j.leukres.2011.01.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2010] [Revised: 12/31/2010] [Accepted: 01/10/2011] [Indexed: 11/29/2022]
|
10
|
Ferreres JR, Marcoval J, Vicente A, Medina M, Lailla JM, González-Enseñat MA. [Imported donovanosis in an adolescent girl]. Actas Dermosifiliogr 2008; 99:574-575. [PMID: 18682176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023] Open
|
11
|
Affiliation(s)
- Sowmya Kaimal
- Department of Dermatology and STD, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
| | | |
Collapse
|
12
|
Abstract
We report on a patient from a London clinic, (a Jamaican heterosexual man known to have herpes) who has donovanosis and syphilis in a single genital ulcer. The case highlights the importance of careful clinical examination of genital ulcers.
Collapse
Affiliation(s)
- M Samuel
- Department of Genitourinary Medicine, Kings College Hospital, Caldecot Centre, 15-22 Caldecot Road, Camberwell, London SE5 9RS, UK.
| | | | | | | | | |
Collapse
|
13
|
Rashid RM, Janjua SA, Khachemoune A. Granuloma inguinale: a case report. Dermatol Online J 2006; 12:14. [PMID: 17459300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/15/2023] Open
Abstract
Granuloma inguinale is common in certain regions of the world, however, it is rarely reported in the United States. It is the result of infection by Calymmatobacterium granulomati, although current literature proposes to re-classify this organism as Klebsiella granulomati. Here we report a case of granuloma inguinale, review the literature, and discuss historical context, treatment options, and differential diagnosis.
Collapse
|
14
|
Affiliation(s)
- J Richens
- Centre for Sexual Health and HIV Research, The Mortimer Market Centre, London WC1E 6AU, UK.
| |
Collapse
|
15
|
Caumes E, Janier M, Dupin N, Alcaraz I, Timsit FJ, Denoeux JP. [Donovanosis (inguinal granuloma)]. Ann Dermatol Venereol 2006; 133:2S35. [PMID: 17072171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
|
16
|
Abstract
Genital elephantiasis is an important medical problem in the tropics. It usually affects young and productive age group, and is associated with physical disability and extreme mental anguish. The majority of cases are due to filariasis; however, a small but significant proportion of patients develop genital elephantiasis due to bacterial sexually transmitted infections (STIs), mainly lymphogranuloma venereum (LGV) and donovanosis. STI-related genital elephantiasis should be differentiated from elephantiasis due to other causes, including filariasis, tuberculosis, haematological malignancies, iatrogenic, or dermatological diseases. Laboratory investigations like microscopy of tissue smear and nucleic acid amplification test for donovanosis, and serology and polymerase chain reaction for LGV may help in the diagnosis, but in endemic areas, in the absence of laboratory facilities, diagnosis largely depends on clinical characteristics. The causative agent of LGV, Chlamydia trachomatis serovar L1-L3, is a lymphotropic organism which leads to the development of thrombolymphangitis and perilymphangitis, and lymphadenitis. Long-standing oedema, fibrosis and lymphogranulomatous infiltration result in the final picture of elephantiasis. Elephantiasis in donovanosis is mainly due to constriction of the lymphatics which are trapped in the chronic granulomatous inflammatory response generated by the causative agent, Calymmatobacterium (Klebsiella) granulomatis. The LGV-associated genital elephantiasis should be treated with a prolonged course of doxycycline given orally, while donovanosis should be treated with azithromycin or trimethoprim-sulphamethoxazole combination given for a minimum of three weeks. Genital elephantiasis is not completely reversible with medical therapy alone and often needs to be reduced surgically.
Collapse
Affiliation(s)
- Somesh Gupta
- Department of Dermatology and Venereology, Chandigarh, India.
| | | | | | | | | | | |
Collapse
|
17
|
Abstract
The authors present a case of disseminated granuloma inguinale with bilateral psoas abscesses. Infection with calymmatobacterium granulomatis is usually localized to the genital organs but rarely may be disseminated. A search of the literature revealed that only two cases of psoas abscesses due to calymmatobacterium granulomatis were previously reported
Collapse
Affiliation(s)
- W West
- Section of Radiology, Department of Surgery, The University of the West Indies, Mona, Jamaica.
| | | | | | | | | |
Collapse
|
18
|
Abstract
Although sexually transmitted diseases (STDs) are underreported and underrecognized, they are a major source of morbidity, mortality, and represent a major socioeconomic cost in developing and industrialized nations. Individuals who develop STDs are often coinfected with human immunodeficiency virus (HIV). Coinfection with HIV both facilitates the natural history of STDs and worsens the clinical picture. The objective of this article is to provide a review to the practicing clinician on the epidemiology, clinical manifestations, methods of diagnosis, and treatment for four cutaneous STDs--chancroid, genital herpes, granuloma inguinale, and lymphogranuloma venereum--in coinfected HIV patients.
Collapse
Affiliation(s)
- Jashin J Wu
- Department of Dermatology, University of California College of Medicine Irvine, Irvine, California, USA
| | | | | | | |
Collapse
|
19
|
Ramos-E-Silva M. Facial and oral aspects of some venereal and tropical diseases. Acta Dermatovenerol Croat 2004; 12:173-80. [PMID: 15369643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
Diseases of the tropical areas include some venereal diseases, and they are still very prevalent in some countries; Brazil is one of them. Very few cases are originated in large cities, as Rio de Janeiro, but at the University Hospital of the Federal University of Rio de Janeiro we also see those patients who come from the interior of the State of Rio de Janeiro or from other states to seek medical care at better equipped hospitals for this type of investigation and therapy. Venereal and tropical dermatoses have many different cutaneous manifestations and may affect skin in several locations. The face is one of the affected areas especially when the disease has a predilection for cartilage, oral and/or nasal mucosa. Alterations observed on the skin of the face and on the mucosa of the mouth of some tropical diseases, such as leprosy, leishmaniasis, paracoccidioidomycosis, donovanosis, and syphilis, as they are observed in Brazil, are presented and discussed in this article.
Collapse
Affiliation(s)
- Marcia Ramos-E-Silva
- Dermatology Sector, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro Brazil.
| |
Collapse
|
20
|
|
21
|
Abstract
Donovanosis, a chronic cause of genital ulceration, has recently been the subject of renewed interest after a long period of relative obscurity. The causative organism, Calymmatobacterium granulomatis, has been cultured for the first time in many years and a polymerase chain reaction diagnostic using a colorimetric detection system has been developed. Phylogenetic analysis confirms close similarities with the genus Klebsiella and a proposal made that C granulomatis be reclassified as Klebsiella granulomatis comb nov. Azithromycin has emerged as the drug of choice and should be used if the diagnosis is confirmed or suspected. In donovanosis endemic areas, syndromic management protocols for genital ulceration may need to be adapted locally. A significant donovanosis epidemic was reported in Durban from 1988-97 but the current status of this epidemic is unclear. The donovanosis elimination programme among Aboriginals in Australia appears successful and is a model that could be adopted in other donovanosis endemic areas. Overall, the incidence of donovanosis seems to be decreasing. Increased attention would undoubtedly be paid to donovanosis if policy makers recognised more readily the importance of genital ulcers in fuelling the HIV epidemic.
Collapse
|
22
|
Fletcher HM, Rattray CA, Hanchard B, Vaughan K, West WM. Disseminated donovanosis (granuloma inguinale) with osteomyelitis of both wrists. W INDIAN MED J 2002; 51:194-6. [PMID: 12501553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
Abstract
Donovanosis is a sexually transmitted infection which presents with genital ulceration and inguinal lymphadenopathy. Rarely, it presents with extra-genital manifestations. We present a case of disseminated donovanosis with cervical ulceration, massive pelvic lymphadenopathy, osteomyelitis of the wrists and septic arthritis of the knees and right elbow. A 23-year-old gravida two presented with wasting, oedema, ascites, bilateral iliac lymphadenopathy, anaemia and a large ulcer of the cervix uteri. Two months later in the outpatient clinic, she was much improved but still had post-coital bleeding and a hyperaemic cervix, suggestive of persistent infection. The course of antibiotics was therefore repeated. Histopathological examination of a specimen from colposcopic biopsy of the cervix uteri revealed granuloma inguinale. She improved after several courses of antibiotics, blood transfusion, surgical débridement and aspiration of affected joints.
Collapse
Affiliation(s)
- H M Fletcher
- Departments of Obstetris, Gynaecology and Child Health, Pathology and Surgery, Radiology, Anaesthesia and Intensive Care, University of the West Indies, Kingston 7, Jamaica, West Indies.
| | | | | | | | | |
Collapse
|
23
|
van der Griend B, Rane A, Green E. An uncommon cause of a destructive vulval lesion. Aust N Z J Obstet Gynaecol 2001; 41:459-60. [PMID: 11787928 DOI: 10.1111/j.1479-828x.2001.tb01332.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
We present a case of a 39-year-old woman with a vulval lesion, which macroscopically looked consistent with a fungating squamous cell carcinoma of the vulva. However, further investigations demonstrated a less common cause for this presentation.
Collapse
|
24
|
Affiliation(s)
- R W Roest
- Department of Dermatovenereology, University Hospital Dijkzigt, Rotterdam, The Netherlands.
| | | |
Collapse
|
25
|
Abstract
OBJECTIVE To incorporate the first polymerase chain reaction (PCR) assay for Calymmatobacterium granulomatis into a colorimetric detection system for use in routine diagnostic laboratories. METHODS A capture oligonucleotide specific for the Klebsiella phoE gene was covalently linked to tosyl activated magnetic beads. Biotinylated phoE PCR products obtained from 14 positive specimens from patients with donovanosis and isolates of Klebsiella pneumoniae, K rhinoscleromatis, and K ozaenae were cleaved with HaeIII for the purpose of differentiation, captured by the prepared beads, and subjected to standard EIA detection methodology. Eight samples from unrelated genital conditions underwent the same procedure. It was anticipated from the sequence data that the biotinylated fragment would be cleaved from the capture oligonucleotide target region in the three Klebsiella phoE products (that is, a negative colorimetric result) while the entire fragment of interest would remain intact in the positive C granulomatis phoE products (that is, a positive colorimetric result). RESULTS All 14 positive specimens from patients with donovanosis gave strong colorimetric readings with this detection system. Isolates of K pneumoniae, K rhinoscleromatis, K ozaenae, and the eight specimens from unrelated genital conditions were negative. CONCLUSION The successful development of a colorimetric detection system for C granulomatis incorporating two levels of specificity enables the molecular diagnosis of this condition to be undertaken by routine diagnostic laboratories. This should have an important role in the Australian government's campaign to eradicate donovanosis by 2003 though the test still needs to undergo trials and be validated using a larger number of samples from geographically diverse parts of the world in order to ascertain the generalisability of the methodology.
Collapse
Affiliation(s)
- J S Carter
- Centre for Indigenous Natural and Cultural Resource Management, Faculty of Aboriginal, Northern Territory University, Darwin, Australia.
| | | |
Collapse
|
26
|
Füessl HS. [Painless ulcer of the penis. Granuloma inguinale tropicum]. MMW Fortschr Med 2000; 142:43-4. [PMID: 10810869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
|
27
|
Bowden FJ, Skov SJ. Treating donovanosis. Aust Fam Physician 1999; 28:1103-4. [PMID: 10615749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
|
28
|
Brown TJ, Yen-Moore A, Tyring SK. An overview of sexually transmitted diseases. Part I. J Am Acad Dermatol 1999; 41:511-32. [PMID: 10495370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
Sexually transmitted diseases are a persistent problem in the United States and throughout the world. Many of these infections involve the skin and may be encountered in the field of dermatology. This 3-part review highlights the cutaneous features, diagnosis, and treatment of 11 of the most commonly encountered sexually transmitted diseases, other than AIDS. However, this review does not cover sexually transmitted diseases such as chlamydia, which do not regularly have cutaneous manifestations. Part 1 focuses on syphilis, disseminated gonococcal infection, chancroid, lymphogranuloma venereum, granuloma inguinale, and genital herpes. Additional features, such as epidemiology and transmission of the organism, are discussed when applicable.
Collapse
|
29
|
National guideline for the management of donovanosis (granuloma inguinale). Clinical Effectiveness Group (Association of Genitourinary Medicine and the Medical Society for the Study of Venereal Diseases). Sex Transm Infect 1999; 75 Suppl 1:S38-9. [PMID: 10616381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023] Open
MESH Headings
- Anti-Bacterial Agents/therapeutic use
- Azithromycin/therapeutic use
- Ciprofloxacin/therapeutic use
- Contraindications
- Doxycycline/therapeutic use
- Female
- Genital Diseases, Female/diagnosis
- Genital Diseases, Female/drug therapy
- Genital Diseases, Female/microbiology
- Genital Diseases, Male/diagnosis
- Genital Diseases, Male/drug therapy
- Genital Diseases, Male/microbiology
- Gentamicins/therapeutic use
- Granuloma Inguinale/diagnosis
- Granuloma Inguinale/drug therapy
- Humans
- Infectious Disease Transmission, Vertical
- Male
- Pregnancy
- Pregnancy Complications, Infectious/diagnosis
- Pregnancy Complications, Infectious/drug therapy
- Pregnancy Complications, Infectious/microbiology
- Ulcer/diagnosis
- Ulcer/drug therapy
- Ulcer/microbiology
Collapse
|
30
|
Golledge C. A painless penile ulcer. Aust Fam Physician 1999; 28:605. [PMID: 10399396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Affiliation(s)
- C Golledge
- Western Australian Centre for Pathology and Medical Research, Western Australia
| |
Collapse
|
31
|
Affiliation(s)
- J Carter
- Faculty of Aboriginal and Torres Strait Islander Studies, Northern Territory University, Menzies School of Health Research, and AIDS/STD Unit, Disease Control, Territory Health Services, Darwin, Australia
| | | | | | | | | |
Collapse
|
32
|
|
33
|
Abstract
A case of granuloma inguinale (GI) presenting as a lateral neck mass in a 4-month-old, HIV-positive infant is described. The histological features of the mass were typical of GI, with numerous macrophages containing intracellular organisms with a "closed-safety-pin" appearance. This is a rare occurrence, and the mode of transmission of infection is discussed. An awareness of GI in infants by both clinicians and pathologists is important to prevent morbidity and allow for prompt institution of appropriate treatment.
Collapse
Affiliation(s)
- D Govender
- Department of Anatomical Pathology, University of Natal Medical School, Private Bag 7, Congella, Durban, 4013, South Africa
| | | | | |
Collapse
|
34
|
|
35
|
Cliff S, Wilson A, Wansborough-Jones M, Ash S. Disseminated granuloma inguinale secondary to cervical infection. J Infect 1998; 36:129-30. [PMID: 9515686 DOI: 10.1016/s0163-4453(98)93738-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
|
36
|
Abstract
Granuloma inguinale (donovanosis) is seen predominantly in adults (it rarely occurs in children) and mainly affects genital skin and mucosa. Infection occurs at other skin and mucosal sites, and hematogenous dissemination to bone also has been described. The infection responds dramatically to appropriate antibiotic treatment. We present two cases of granuloma inguinale occurring in children (8 months and 5 months of age) causing mastoiditis and external ear discharges. A temporal lobe abscess also developed in the 8-month-old child. Subsequent computed tomography scans showed marked improvement in the brain lesion after treatment. The second child had a polypoid mass in the middle ear that on biopsy showed the features of granuloma inguinale. The mother of this child had biopsy-proven granuloma inguinale of the uterine cervix. These cases indicate that granuloma inguinale can be transmitted during vaginal delivery, and careful cleansing of neonates born to infected mothers is recommended.
Collapse
Affiliation(s)
- D Govender
- Department of Anatomical Pathology, University of Natal Medical School, Congella, Durban, South Africa
| | | | | |
Collapse
|
37
|
Affiliation(s)
- S M Manders
- Division of Dermatology, University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School at Camden, USA
| | | |
Collapse
|
38
|
Affiliation(s)
- G Hart
- Sexually Transmitted Diseases Control Branch, South Australian Health Commission, Adelaide, Australia
| |
Collapse
|
39
|
Urso P, Jordan ML. Less common dermatological sexually transmitted diseases. Nurse Pract Forum 1996; 7:30-33. [PMID: 8788661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Affiliation(s)
- P Urso
- University of Hawaii School of Nursing, USA
| | | |
Collapse
|
40
|
Kramer PB. Knowledge about AIDS and follow-up compliance in patients attending a sexually transmitted disease clinic in the highlands of Papua New Guinea. P N G Med J 1995; 38:178-90. [PMID: 9522857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
In a survey of 300 consecutive new attenders at the Porgera Health Centre Sexually Transmitted Disease Clinic information was obtained regarding knowledge about AIDS from male and female attenders. The differences between the sexes regarding a variety of socioeconomic variables, knowledge about AIDS and their compliance to follow-up appointments were studied as well as possible relationships between these social variables and the degrees of AIDS knowledge and compliance. Males tended to originate from further afield, be more educated, be either in salaried employment or not working at all, and be single as compared to females. They also admitted to more extramarital sexual contacts and received more adequate treatment. Knowledge about AIDS was also significantly higher amongst male attenders and in this group was correlated strongly with overall educational attainment and employment status but did not show any relationship with the number of extramarital contacts admitted to. Only 9% of the patients knew about condoms and their role in prevention. Follow-up compliance was generally poor, and not significantly higher in those with higher scores of knowledge about AIDS, but showed a relationship with the type of disease being treated and with the ultimate adequacy of treatment received.
Collapse
Affiliation(s)
- P B Kramer
- Porgera Health Centre, Enga Province, Papua New Guinea
| |
Collapse
|
41
|
Affiliation(s)
- L F Morris
- Department of Dermatology, University of Texas-Houston Medical School
| | | | | |
Collapse
|
42
|
Martin DH, Mroczkowski TF. Dermatologic manifestations of sexually transmitted diseases other than HIV. Infect Dis Clin North Am 1994; 8:533-82. [PMID: 7814834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
This article focuses on the common skin manifestations of sexually transmitted diseases. A number of unusual skin lesions associated with these diseases are shown, and pathogenesis and treatment are briefly presented. This article will be most useful as a reference for the formulation of the differential diagnosis of genital area skin lesions.
Collapse
Affiliation(s)
- D H Martin
- Department of Medicine, Louisiana State University School of Medicine, New Orleans 70112
| | | |
Collapse
|
43
|
Goens JL, Schwartz RA, De Wolf K. Mucocutaneous manifestations of chancroid, lymphogranuloma venereum and granuloma inguinale. Am Fam Physician 1994; 49:415-8, 423-5. [PMID: 8304262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
The sexually transmitted diseases chancroid, lymphogranuloma venereum and granuloma inguinale should be familiar to physicians who care for patients at risk. The mucocutaneous manifestations of these three diseases must be distinguished from the lesions of other venereal diseases, such as primary syphilis and genital herpes simplex. Human immunodeficiency virus (HIV) infection should always be considered in patients with any venereal disease, since sexually transmitted diseases often occur together. Furthermore, the genital erosions that occur in patients with these three disorders may predispose them to HIV infection.
Collapse
Affiliation(s)
- J L Goens
- Free University of Brussels, Belgium
| | | | | |
Collapse
|
44
|
O'Farrell N, Hoosen AA, Coetzee KD, van den Ende J. Genital ulcer disease: accuracy of clinical diagnosis and strategies to improve control in Durban, South Africa. Genitourin Med 1994; 70:7-11. [PMID: 8300105 PMCID: PMC1195171 DOI: 10.1136/sti.70.1.7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
OBJECTIVE To investigate the accuracy of clinical diagnosis in genital ulcer disease (GUD); to devise management strategies for improving the control of GUD and thereby limit the spread of HIV-1 infection. DESIGN Clinical and microbiological assessment of GUD in men and women. The index of suspicion, diagnostic accuracy, diagnostic efficiency and positive and negative predictive values of a clinical diagnosis were investigated. SETTING City Health Sexually Transmitted Diseases Clinic, King Edward VIII Hospital, Durban, South Africa. PARTICIPANTS 100 men and 100 women with genital ulcers. RESULTS The accuracy of a clinical diagnosis was, in men: lymphogranuloma venereum (LGV) 66%, donovanosis 63%, chancroid 42%, genital herpes 39%, primary syphilis 32%, mixed infections 8%, and in women; secondary syphilis 94%, donovanosis 83%, genital herpes 60%, primary syphilis 58%, chancroid 57%, LGV 40%, mixed infections 14%. Overall, diagnostic efficiency was greater in women than in men. When compared with other causes of GUD, donovanosis ulcers bled to the touch and were larger and not usually associated with inguinal lymphadenopathy. In women, extensive vulval condylomata lata were readily differentiated from all other causes of GUD. CONCLUSION A clinical diagnosis in genital ulceration was less accurate in men than in women. The diagnostic accuracies for donovanosis and secondary syphilis were relatively high but for most other conditions were low. Differences between clinical and laboratory diagnostic accuracies may reflect similarities between the clinical appearances of the various causes of GUD, the presence of mixed infections, atypical ulceration due to longstanding disease, and insensitive laboratory tests. In this community all large ulcers should be treated empirically for syphilis and donovanosis. Uncircumcised men with GUD are an important HIV core or "superspreader" group locally, and prevention strategies should include counselling and health education in the light of the inaccuracy of clinical diagnosis found in this study. The development of rapid accurate tests for GUD is urgently required.
Collapse
Affiliation(s)
- N O'Farrell
- City Health STD Department, King Edward VIII Hospital, Durban, South Africa
| | | | | | | |
Collapse
|
45
|
Joseph AK, Rosen T. Laboratory techniques used in the diagnosis of chancroid, granuloma inguinale, and lymphogranuloma venereum. Dermatol Clin 1994; 12:1-8. [PMID: 8143374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
The preceding discussion summarized the historical, modern, and evolving laboratory techniques for the diagnosis of chancroid, GI, and LGV. The correct diagnosis of these sexually transmitted diseases, which are uncommon in the United States and Europe but often endemic in Africa, Asia, and South American, can usually be made if appropriately selected laboratory techniques are used to confirm the presumptive clinical impression.
Collapse
Affiliation(s)
- A K Joseph
- Department of Dermatology, Baylor College of Medicine, Houston, Texas
| | | |
Collapse
|
46
|
Abstract
OBJECTIVE To describe the epidemiological and clinical features of donovanosis and their relevance to the possible coincident risk of HIV-1 transmission in patients attending an STD clinic. DESIGN Assessment of patients with donovanosis diagnosed by the detection of Donovan bodies on tissue smears stained by the RapiDiff technique. SETTING City Health STD Clinic, King Edward VIII Hospital, Durban, South Africa. PARTICIPANTS One hundred and seventy one patients with donovanosis. RESULTS Donovan bodies were detected in 171 (130 men, 41 women). Ulcers were present for longer than 28 days in 72 (55.4%) men and 19 (46.3%) women. Ninety five (55.6%) came from rural areas. Lesions were ulcero-granulomatous in 162, hypertrophic in eight and necrotic in one. Anal lesions were detected in one woman. Only one of 21 regular sexual partners examined was infected with donovanosis. Complete healing was observed in 41 (24%) who attended for follow up. Extensive lesions were sometimes observed in pregnant women. Serological tests for syphilis were positive in 40 (23.4%). HIV-1 antibodies were detected in 4/48 men and 0/15 women who underwent HIV testing. Donovanosis ulcers in three HIV-1 seropositive men were cured by standard antibiotic therapy. CONCLUSIONS Delay in presentation, extensive areas of genital ulceration and lack of co-existent infection with donovanosis among sexual partners were notable features. Primary health care facilities in rural areas do not appear to be providing an adequate service for patients with donovanosis. HIV control programmes should consider specific measures aimed at eradicating donovanosis in areas where the condition is prevalent.
Collapse
Affiliation(s)
- N O'Farrell
- City Health STD Clinic, King Edward VIII Hospital, Durban, Natal, South Africa
| |
Collapse
|
47
|
Engelkens HJ, Niemel PL, Menke HE, Stolz E. [Granuloma inguinale (donovanosis): vigilance should be exercised]. Ned Tijdschr Geneeskd 1993; 137:396-9. [PMID: 8446195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Affiliation(s)
- H J Engelkens
- Afd. Dermatologie en Venereologie, Academisch Ziekenhuis Rotterdam-Dijkzigt
| | | | | | | |
Collapse
|
48
|
Affiliation(s)
- V N Sehgal
- Department of Dermatology & Venereology, Maulana Azad Medical College, New Delhi, India
| | | |
Collapse
|
49
|
Abstract
OBJECTIVES An indirect immunofluorescence technique applied to paraffin embedded tissue sections of lesions containing Donovan bodies was evaluated as a serological test for the diagnosis of granuloma inguinale. METHODS Sera from patients with proven granuloma inguinale, other sexually acquired genital ulcerations and blood donors from areas where granuloma inguinale is rarely encountered as well as from disease-endemic regions were tested. Sera were tested either unabsorbed or following absorption with whole Klebsiella pneumoniae bacteria. RESULTS Using unabsorbed sera at a dilution of 1:160 the test was found to have a sensitivity of 100%, specificity of 98%, positive predictive value (PPV) of 89% and negative predictive value (NPV) of 100%. There proved to be no advantage in preabsorbing sera with K. pneumoniae antigen. CONCLUSIONS In the absence of culture methods for Calymmatobacterium granulomatis, an indirect immunofluorescence technique may prove valuable for the diagnosis of individual cases of granuloma inguinale and as an epidemiological tool in studies of the disease.
Collapse
Affiliation(s)
- A L Freinkel
- Department of Anatomical Pathology, University of the Witwatersrand Medical School, Johannesburg, South Africa
| | | | | | | |
Collapse
|
50
|
Affiliation(s)
- E Van Dyck
- Department of Microbiology, Institute of Tropical Medicine, Antwerp, Belgium
| | | |
Collapse
|