Granuloma inguinale is a sexually-transmitted disease that causes genital ulcers. It is uncommon in developed countries but is endemic in certain countries.
Causative organism: Klebsiella granulomatis (genus Donovania or Calymmatobacterium)
Endemic areas: India, Papau New Guinea, Australia, Brazil, South Africa
Risk groups:
(1) residence in endemic area
(2) sex worker
(3) sexually promiscuous
Clinical features:
(1) The patient usually presents with a chronic painless genital ulceration.
(2) Other sites (perianal, oral, other) may be affected.
(3) There is granulomatous inflammation in inguinal lymph nodes which may cause ulceration of overlying skin or sinus tracts.
(4) Occasionally some patients may have an extensive, locally destructive and mutilating process.
Laboratory findings:
(1) Historically the diagnosis was made by demonstration of Donovan bodies (bacteria with bipolar staining within the cytoplasm of monocytes) within smears or histologic sections.
(2) The organisms can grow in tissue culture (HEp-2 cells, human monocytes).
(3) PCR is probably the most reliable method of laboratory identification.
