ContentsSynopsisCodesLook ForDiagnostic PearlsDifferential Diagnosis & PitfallsBest TestsManagement PearlsTherapyReferencesView all Images (39)
Granuloma inguinale
See also in: Cellulitis DDx,Anogenital
Other Resources UpToDate PubMed

Granuloma inguinale

See also in: Cellulitis DDx,Anogenital
Contributors: Susan Burgin MD, Edith Lederman MD, Noah Craft MD, PhD
Other Resources UpToDate PubMed

Synopsis

Granuloma inguinale (donovanosis) is a sexually transmitted infection (STI) caused by the gram-negative Klebsiella granulomatis. Previously more common in Australia, it is now extremely rare in that country. Approximately 100 cases occur in the United States each year. The disease is reported to be more commonly found in tropic and subtropic regions, including India, Southern Africa, South America, Southeast Asia, New Guinea, and the Caribbean.

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

Subscription Required

Diagnostic Pearls

Subscription Required

Differential Diagnosis & Pitfalls

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

Best Tests

Subscription Required

Management Pearls

Subscription Required

Therapy

Subscription Required

References

Subscription Required

Last Reviewed:05/24/2018
Last Updated:09/22/2021
Copyright © 2021 VisualDx®. All rights reserved.
Granuloma inguinale
See also in: Cellulitis DDx,Anogenital
Granuloma inguinale : Penis, Perianal-anus, Red color, Groin, Smooth papules, Smooth nodules, Ulcers, Labia minora
Clinical image of Granuloma inguinale
An ulcerated bubo and an ulcer on the penis.
Copyright © 2021 VisualDx®. All rights reserved.