Granuloma Inguinale (Donovanosis)

Granuloma Inguinale (Donovanosis) in English

Medical Words

According to abbreviationfinder.org, the venereal disease granuloma inguinale or donovanosis is particularly common in tropical countries. If treatment is started early, the infection can often be completely cured.

What is granuloma inguinale?

Granuloma inguinale is one of the infectious sexually transmitted diseases (diseases that are transmitted through sexual intercourse). The term Donovanosis goes back to the tropical doctor Charles Donovan, who first described the disease in 1905.

Although granuloma inguinale is distributed worldwide, there is an increased incidence in tropical and subtropical countries (e.g. in Central and South America or Africa). Men are affected twice as often as women by granuloma inguinale.

Since Donovanosis is not treated adequately in many cases, it often takes a chronic course. Typical symptoms of present granuloma inguinale are ulcers that form on the genitals.

Causes

Donovanosis is caused by the bacterium Klebsiella granulomatis. Because of this fact, the bacterium is also known as Donovan bodies. The bacterium is immobile and encapsulated.

Transmission of the bacterium Klebsiella granulomatis can occur through direct skin contact; especially this happens during intercourse. Where the causative agent of donovanosis penetrates the skin, it causes a pustules, which is also called the primary effect in medicine. Although the granuloma inguinale pustule is usually painless at first, ulcers usually develop later.

These are susceptible to bacterial infection, which can cause further bacterial infection. As a result, Donovanosis can lead to pain. Very rarely, the bacteria responsible for granuloma inguinale can get into organs or joints via the blood and cause problems there.

Symptoms, Ailments & Signs

Granuloma inguinale does not initially cause any clear symptoms. The first sign is the visible skin changes. Small, reddish nodules usually form at the point where the pathogens penetrated the skin. These are not painful and will go away on their own after a few days. Additional ulcers develop around the skin defect.

These are usually flesh-colored and look punched out, but usually do not cause any noticeable symptoms either. Pain occurs only in the event of a bacterial superinfection. Granuloma inguinale usually occurs in the pubic area. In men it is usually localized on the penis, in women in the area of ​​​​the inner labia. The skin change is often associated with swelling and begins to hurt as it progresses.

The neighboring lymph nodes are also swollen and painful to the touch. The disease can cause accompanying symptoms such as fever, malaise and nausea. In the case of a superinfection, there is a risk of blood poisoning, which is first expressed by the characteristic reddish stripe that leads away from the infected area and towards the heart. In rare cases, the pathogens reach other parts of the body and cause joint or bone pain, for example.

Diagnosis & History

Granuloma inguinale is usually diagnosed by detecting the bacterium Klebsiella granulomatis. This is possible, for example, with the help of a swab or a tissue sample of the affected tissue.

If a corresponding sample under the microscope cannot clearly confirm the presence of Donovan bodies, the attending physician has the option of first creating a cell culture, which is then examined for the presence of granuloma inguinale.

Other diseases must also be ruled out as the cause of symptoms that are similar to those of donovanosis; these include, for example, diseases caused by the herpes simplex virus type 2 or syphilis.

If detected and treated early, Donovanosis is usually positive and symptoms heal completely. However, if a granuloma inguinale has already spread and has been present for a long time, it can lead to scars, a narrowed urethra or even mutilation.

Complications

As a rule, granuloma inguinale does not lead to any special complications. It can be treated relatively well and easily if treated early. There is no reduction in life expectancy or other symptoms. In most cases, granuloma inguinale leads to reddening of the skin or the formation of small nodules on the affected regions.

These skin areas are also affected by itching, which can be very uncomfortable for the patient. Furthermore, there is severe pain in the genitals, so that the patient’s sex life is negatively influenced by the granuloma inguinale. Although only a few symptoms occur, they can have a very negative impact on the patient’s everyday life and lead to general exhaustion.

Granuloma inguinale is usually treated with antibiotics and can thus be fought relatively well. There are no further complications. In rare and severe cases, scars can form. Likewise, it cannot be ruled out that the granuloma inguinale may not recur after treatment. If not treated early, a tumor can form on the skin and destroy tissue.

When should you go to the doctor?

If changes occur in the intimate area immediately after unprotected sexual intercourse or intimate skin contact with another person, a doctor should be consulted. In case of itching, reddening of the skin, a burning sensation or general malaise, it is advisable to consult a doctor. If swelling, growths, ulcers or the formation of nodules in the genital area occur, a doctor should be consulted as soon as possible.

If open sores develop on the external or internal genitals as a result of the existing symptoms, medical attention is required. Other germs and pathogens can enter the organism via the open skin areas. In severe cases, there is a risk of blood poisoning. Therefore, in the event of unusual changes or inflammation, a check-up should be initiated in good time.

If the existing symptoms in the genitals spread further or last for several days, a doctor is needed. If the person concerned suffers from increased stress or irritability due to the symptoms, a doctor is needed. A doctor should be consulted in the event of emotional and psychological problems, persistent emotions such as disgust or guilt, or a feeling of illness. If there are sexual dysfunctions, complaints during the sexual act or a reduced libido, the person concerned should consult a doctor.

Treatment & Therapy

If granuloma inguinale is discovered early, a successful therapeutic component can often be the administration of antibiotics. On average, the antibiotic treatment of Donovanosis takes about 2 to 3 weeks. If antibiotic therapy for granulomas inguinale proves to be successful, healing of the affected skin areas usually begins after about a week.

Smaller nodules often heal in the presence of donovanosis without leaving scars on the affected areas of the skin. However, larger ulcers that have healed can lead to scarring. In individual cases, relapses can occur after healing has taken place; these are then usually counteracted with follow-up examinations.

Doctors recommend avoiding sexual contact during the period of therapy. If a granuloma inguinale is not treated early or not at all, destruction of the affected tissue can result. In extreme cases, if Donovanosis is left untreated, a malignant skin cancer can form on the affected skin areas.

Outlook & Forecast

If the granuloma inguinale is recognized and treated early, the patient can count on a favorable prognosis. In these cases there is a good chance that the disease can be completely cured.

The swellings and ulcers gradually recede through the administration of medicines until there are no symptoms at all. The functionality of the sexual organs and the urethra are then restored. No long-term consequences or limitations are to be expected in these patients.

Without the use of medical care or with a delayed start of therapy, the disease can become chronic. This worsens the prognosis in these patients. There is a possibility that scars will form later or that the urethra will be narrowed.

This leads to sequelae and discomfort when urinating. In some patients, this can have a long-term effect on kidney function. In severe cases, mutilation of the genitals or urethra can occur. As a result, sexual dysfunction or reduced libido can be expected.

As a result, those affected are usually diagnosed with mental disorders, which contribute to a deterioration in their well-being and quality of life. In rare cases, granuloma inguinale leads to the development of skin cancer. If left untreated, the ulcers can mutate and become life-threatening.

Prevention

Since donovanosis is a sexually transmitted disease, the main way to prevent it is to practice safe sex (using condoms ). This is especially true for countries where there is a high risk of infection; these countries include Papua New Guinea and Brazil. A chronic course of Donovanosis can be prevented, above all, with early, effective therapy of acute Donovanosis.

Aftercare

In the case of granuloma inguinale, the affected person has very few measures or options for aftercare. The patient is primarily dependent on a complete treatment of the disease, with early treatment and detection of the granuloma inguinale being very important. If granuloma inguinale is recognized and treated early, there are usually no further complications. A complete cure of this disease is possible.

After the treatment, no further follow-up measures are usually necessary. The granuloma inguinale is usually treated with the help of medication, with antibiotics being used in particular. The person concerned should always take it as directed by a doctor. Even when the granuloma inguinale has healed, the antibiotics should still be taken to the end in order to treat the disease completely.

If there are scars, they can also be treated with surgery. Since the granuloma inguinale can reappear even after the granuloma inguinale has healed, regular examinations are very useful. Tests for cancer are also very useful, as tumors can form in the affected areas.

You can do that yourself

Patients with granuloma inguinale suffer from both the intense itching caused by the ulcers and a sense of shame about the disease. First of all, it is particularly relevant to follow the instructions for taking the prescribed medication exactly and to follow other advice from the doctor treating you. In order not to endanger their general well-being, patients pay particular attention to the occurrence of any side effects and seek medical help immediately in such cases.

In order for the acute symptoms to subside quickly and not worsen, it is crucial to resist the itch and not scratch the genital sores. Against this background, thorough personal hygiene and adapted intimate hygiene must be taken into account, which must be discussed with the responsible doctor.

In this context, suitable underwear can also help to prevent the unpleasant itching from becoming even worse. Patients therefore prefer clothing made of natural fibers during the recovery phase and, at best, those made for people with allergies, so as not to provoke further irritation. In general, it is beneficial for regeneration if patients with granuloma inguinale allow themselves a lot of rest during drug treatment and do not overload themselves physically, for example with sporting activities.

Granuloma Inguinale (Donovanosis)