Granuloma Inguinale

Key Points
Sexually transmitted infection
Caused by the bacterium Klebsiella granulomatis
Consists of nodular lesions which ulcerate and enlarge as the condition progresses

Granuloma inguinale is a sexually transmitted bacterial infection. It consists of raised, nodular lesions, primarily in the genital and perianal areas. Over time, the lesions ulcerate and enlarge, and become red and velvety in texture. Lesions are generally not painful, though may be prone to bleeding. The hypertrophic type of the condition will appear differently, consisting of dry masses resembling genital warts. The necrotic type consists of dry ulcers which resolve into scar tissue.

Granuloma inguinale is caused by the bacteria calymmatobacterium or klebseilla granulomatis. Those persons who are sexually active are at an increased risk of infection. The condition is more common in tropical and subtropical climates. It appears to affect men slightly more than women.

Differential Diagnosis (Other conditions with similar appearance)
Chancroid
Herpes simplex
Lymphogranuloma venereum
Syphilis

Diagnosis
Key Points
Initial diagnosis based on appearance of lesions
Skin Biopsy or other tests may be performed to confirm diagnosis and rule out other conditions

Granuloma inguinale is initially diagnosed based on the appearance of lesions. Health care professionals will then perform a biopsy of the tissue around the lesion to confirm the diagnosis. Other tests may be performed to rule out other conditions.

Treatment
Treated with Antibiotics
Goal of treatment is to eliminate the infection
No sexual activity until the infection heals
*Left untreated, can be very destructive

Granuloma inguinale must be treated by health care professionals, as it can be extremely destructive. Left untreated, it can result in permanent swelling and scarring in the affected area, and secondary conditions as the infection spreads, including heart failure and pneumonia.

Granuloma inguinale is treated with a course of antibiotics which lasts until lesions have healed completely. The most commonly used medications are trimethoprim-sufamethoxazole and doxycycline, though erythromycin, ciprofloxacin and azithromycin are also effective. If antibiotic therapy does not improve symptoms, health care professionals may administer gentamicin intravenously.