Granuloma inguinale, also known as donovanosis or donovania, is a Sexually Transmitted Disease or Infection (STD/STI). It causes ulcers on the genitalia, for which the intra-cellular, gram-negative bacterium, "Klebsiella granulomatis (formerly known as Calymmatobacterium granulomatis)" is responsible. The disease is endemic in some tropical and developing countries like India, Pakistan and Bangladesh and parts of southern Africa, the Caribbean, Papua New Guinea and central Australia. Clinically, the disease is usually characterised by painless, ulcerative lesions on the genitalia or perineum which progress slowly, without regional lymphadenopathy (swelling of lymph glands) — sub-cutaneous granulomas (pseudo-buboes) also may be observed. The lesions are beefy red in appearance due to high vascularity and may bleed. The infection can extend to the pelvis or even the intra-abdominal organs, bones or the mouth. Granuloma inguinale lesions may develop secondary bacterial infections also and can co-exist with other STDs.
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Small, hard, bright-red coloured pustules form around the genitalia up to 12 weeks after infection which do not cause pain or other discomfort. However, they can itch - making them look similar to the skin changes caused by the herpes simplex virus. However, this picture changes. The pustules disintegrate and form flesh-coloured ulcers which spread rapidly. After a short time, they not only cover the originally infected area, but also the surrounding skin areas. This expansion makes it easy to distinguish granuloma inguinale ulcers from the hard chancre.
Lymphadenopathy (swelling of the lymph glands) is also common. This may cause pain during sexual intercourse for women.
There is also the danger that the Klebsiella granulomatis bacteria will spread throughout the body through the bloodstream. In this way, it can affect bones and joints, as well as the liver and other vital organs. The consequences are recurring attacks of fever, progressive anaemia and / or extreme weight loss.
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Diagnosis requires discovering dark-staining Donovan bodies on tissue crush preparation or biopsy as the causative organism of granuloma inguinale is difficult to culture.
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| In the second and third trimester of pregnancy because of the risk of discolouration of teeth and bones, Doxycycline should be avoided although it is compatible with breastfeeding. Sulfonamides occasionally can cause serious kernicterus in those with G6PD deficiency and should be avoided in the third trimester and during breastfeeding. Pregnant and lactating women should therefore be treated with a macrolide regimen (erythromycin or azithromycin) or Homoeopathy. Homeopathy can heal the pus, ulcers, excessive mucous discharge, lymphadenopathy (lymph glands' swelling) or whatever other symptoms, without side effects. People infected with drug resistant bacteria can also be healed. The frequency and intensity of the symptoms keep reducing until everything is healed. |
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