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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. granulomatosis (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