Granuloma inguinale

Last Updated: 2023-07-07

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

ICD11: 1A91

McLeod 1882.

Donovanosis, granuloma venereum.

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

  • Occurring mainly in tropical and subtropical areas
  • Males > females

The causative agent is Klebsiella granulomatis, formerly called Calymmatobacterium granulomatosis or Donovania granulomatosis.

  • In the inguinal region, 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
  • Lymphoedema may develop
  • In women, the infection is often asymptomatic.

  • Anamnesis
  • Clinical picture
  • Biopsy/curettage
  • Nucleic acid amplification techniques are performed in specialised laboratories
  • Laboratory
    • Exclusion of co-infections
    • HIV serology
    • Hepatitis B, C serology
    • Syphilis serology

Pathogen intracellular in macrophages. In Giemsa staining or silvering, bipolar coccoid intracytoplasmic inclusion bodies (Donovan bodies) can be visualised from clusters of pathogens.

Untreated, peripheral extension occurs in 10% of cases and can assume monstrous proportions. Obstruction of the lymphatic vessels can lead to elephantiasis of the penis, scrotum and labia

  • Spontaneous healing is rare
  • During the course, a spinocellular carcinoma may develop

  1. Al-Tawfiq JA, Spinola SM. Haemophilus ducreyi: clinical disease and pathogenesis. Current Opinion in Infectious Diseases 2002;15:43-7.
  2. Janowicz DM, Li W, Bauer ME. Host–pathogen interplay of Haemophilus ducreyi. Current Opinion in Infectious Diseases 2010;23:64-9.
  3. Stümpke G. Ulcus molle. Symptomatologie, Diagnose, Prognose, Therapie, Epidemiologie.  Ulcus Molle und Andere Krankheiten der Urogenitalorgane: Springer Science + Business Media; 1927:75-144
  4. Braun-Falco`s Dermatologie, Venerologie und Allergologie, 7. Auflage