Granuloma inguinale is a primarily sexually transmitted, chronic bacterial infection caused by Klebsiella granulomatis (formerly Calymmatobacterium granulomatis or Donovania granulomatis), an intracellular gram-negative bacillus (1):
- Causative organism similar to Klebsiella spp., leading to discussions on nomenclature
- Usually manifests as genital or anal lesions
- Sexual/anal intercourse is the main source.
- Also can be acquired via fecal route, passage through an infected birth canal, or contact with bare laps of infected individuals (children)
- Granuloma inguinale is a risk factor for acquiring HIV infection.
- Four varieties of skin lesions exist: ulcerovegetative, cicatricial, nodular, and verrucous
- Synonym(s): donovanosis
- <100 cases annually in the United States (mostly foreign travel)
- Endemic: tropical and subtropical regions (e.g., New Guinea, Caribbean, West Indies, Southern India, sub-Saharan Africa, Southeast Asia, Australia, Brazil)
- Incidence higher in blacks in the United States
- Predominant sex: Males are slightly more susceptible.
- Predominant age: 20 to 40 years; rarely seen in children or elderly; no congenital cases reported
Etiology and Pathophysiology
- Repeated exposure is necessary for clinical infection to occur.
- Communicable as long as the infected person remains untreated and bacteria are present
- Bacterial infection caused by the bacillus K. granulomatis/C. granulomatis (previously known as D. granulomatis)
- Residing or traveling in underdeveloped parts of tropical/subtropical countries
- Sexual contact with travelers to endemic area
- Males having unprotected sex with males
- Anal intercourse
- Low socioeconomic background
- HIV positivity
- Safe sex practices
- If infection likely, avoid sexual contact; notify partners.
- Examples of prevention include barrier methods of contraception, avoidance of high-risk sexual activity, and appropriate gynecologic screening (including during the course of pregnancy).
- Sexual contacts within 60 days prior to symptom onset should be evaluated and offered treatment.
- Remaining up to date on HIV care
Commonly Associated Conditions
Can be associated with other STIs, including HIV infection
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Domino, Frank J., et al., editors. "Granuloma Inguinale." 5-Minute Clinical Consult, 27th ed., Wolters Kluwer, 2020. Medicine Central, im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/1688449/all/Granuloma_Inguinale.
Granuloma Inguinale. In: Domino FJF, Baldor RAR, Golding JJ, et al, eds. 5-Minute Clinical Consult. Wolters Kluwer; 2020. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/1688449/all/Granuloma_Inguinale. Accessed May 31, 2023.
Granuloma Inguinale. (2020). In Domino, F. J., Baldor, R. A., Golding, J., & Stephens, M. B. (Eds.), 5-Minute Clinical Consult (27th ed.). Wolters Kluwer. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/1688449/all/Granuloma_Inguinale
Granuloma Inguinale [Internet]. In: Domino FJF, Baldor RAR, Golding JJ, Stephens MBM, editors. 5-Minute Clinical Consult. Wolters Kluwer; 2020. [cited 2023 May 31]. Available from: https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/1688449/all/Granuloma_Inguinale.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Granuloma Inguinale ID - 1688449 ED - Domino,Frank J, ED - Baldor,Robert A, ED - Golding,Jeremy, ED - Stephens,Mark B, BT - 5-Minute Clinical Consult, Updating UR - https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/1688449/all/Granuloma_Inguinale PB - Wolters Kluwer ET - 27 DB - Medicine Central DP - Unbound Medicine ER -