Granuloma inguinale

Last Updated: 2020-08-07

Author(s): Anzengruber F., Navarini A.

ICD11: 1A91

McLeod 1882.

Donovanosis, Granuloma venereum.

Venereal disease caused by the intracellular Calymmatobacterium granulomatis (Donovania granulomatis, Klebsiella granulomatis).

  • Occurs mainly in tropical and subtropical areas
  • Men > Women

The pathogen is Klebsiella granulomatis, formerly known as Calymmatobacterium granulomatosis or Donovania granulomatosis.

  • In the inguinal, genital and anal areas, indolent pustules, papules or subcutaneous nodules appear after about 2 weeks (incubation period 1-10 weeks) after infection. In the course of the disease, confluence or ulceration of the primary florescences may occur. It is not uncommon for abscess formation to occur.
  • This can lead to the development of lymphedema.
  • In women the infection is often asymptomatic.

  • Medical history
  • Clinical picture
  • Biopsy/curettage
  • Nucleic acid amplification techniques are performed in specialized laboratories.
  • Laboratory
    • Exclusion of co-infections
    • HIV serology
    • Hepatitis B, C- Serology
    • Syphilis serology

Pathogen intracellularly in macrophages. In Giemsa staining or silver plating, bipolar cocoid, intracytoplasmic inclusion corpuscles (Donovan corpuscles) can be formed from clusters of pathogens.

If left untreated, in 10% of cases a peripheral expansion occurs, which can assume monstrous proportions. Obstruction of the lymphatic vessels can lead to elephantiasis of the penis, scrotum and labia.

  • A spontaneous healing is rare.
  • In the course of the disease, a spinocellular carcinoma may develop.

Partner co-treatment!
Surgical removal of the exophytic skin alterations.

Topical therapy

  • Antiseptics
  • Iodine-povidone wound ointment, solution, ointment gauze

Systemic therapy

  • Azithromycin p.o. 1g/week over a period of 3 weeks
  • Trimethoprim-Sulfamethoxazole 960mg (equivalent to 160mg/800mg) 2x daily p.o. over 3 weeks
  • Doxycycline p.o. 100 mg 2x daily for 21 days
  • Ciprofloxacin p.o. 500mg 2x daily for 21 days

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