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Granuloma inguinale - Anogenital in
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Granuloma inguinale - Anogenital in

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Contributors: Susan Burgin MD, Edith Lederman MD, Noah Craft MD, PhD
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Synopsis

Granuloma inguinale (donovanosis) is a sexually transmitted disease (STD) caused by the gram-negative Klebsiella granulomatis. Granuloma inguinale is endemic in certain tropical and semitropical regions, including Brazil, New Guinea, Australia, the Caribbean, India, and South Africa. Infection is rare in developed countries, including the United States, but outbreaks have been reported from Canada, Sweden, Italy, France, and Japan.

After an incubation period of days to months, subcutaneous nodules develop at inoculation sites that later erode. The lesions are usually painless, but in atypical variants of the disease, there may be mild pain. Autoinoculation is a common feature, producing so-called "kissing lesions" on adjacent skin and, less commonly, extending to underlying abdominal organs. Subcutaneous granulomas occur in the inguinal area that mimic lymphadenopathy (so-called pseudo-buboes). Without treatment, chronic lesions can result in lymphatic obstruction leading to genital lymphedema and distortion. Extragenital lesions, including oral, bone, and abdominal organs, are reported in 6% of cases. Constitutional symptoms are notably absent.

In rare cases, squamous cell carcinoma may develop in chronically present ulcers.

Granuloma inguinale predisposes individuals to transmission of human immunodeficiency virus (HIV).

Codes

ICD10CM:
A58 – Granuloma inguinale

SNOMEDCT:
28867007 – Granuloma inguinale

Look For

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

The differential diagnosis of ulcerating genital lesions, such as those seen in granuloma inguinale, includes the following:

Best Tests

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Management Pearls

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Therapy

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References

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Last Reviewed: 05/25/2018
Last Updated: 06/22/2018
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Granuloma inguinale - Anogenital in
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Granuloma inguinale : Inguinal lymphadenopathy, Skin ulcer, Widespread male genital, Painless ulcer
Clinical image of Granuloma inguinale
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