GRANULOMA INGUINALE

By Gary M. White, MD

Granuloma inguinale Courtesy Michael O. Murphy, MD


Granuloma inguinale is an indolent, progressive, ulcerative and granulomatous disease of the genitalia caused by the gram-negative bacteria Calymmatobacterium granulomatosis. Giemsa or WrightÂ’s stain of a tissue smear or skin biopsy specimen shows intracytoplasmic inclusion bodies (Donovan bodies) within histiocytes.

Clinical

A beefy, yet asymptomatic ulcer with exuberant granulation tissue on the penis is characteristic of GI, also known as Donovanosis.

Differential Diagnosis

See the penile ulcer.

Treatment

The latest infectious disease treatment guidelines should be consulted. In the past, tetracycline 500 QID for 3-4 weeks has been given. Other antibiotics that have been reported useful include erythromycin, trimethoprim-sulfamethoxazole, streptomycin, gentamicin, chloramphenicol and ceftriaxone and ofloxacin 400 BID.

Additional Pictures

Courtesy Dr. Kaess
Granuloma inguinale

Beefy ulcers and tremendous labial edema. Courtesy Burton Jay, MD
Granuloma inguinale

References

Dermatology Online Journal 22(4)

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