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Excerpt from Granuloma Inguinale (Donovanosis)


Synonyms, Key Words, and Related Terms: GI, sexually transmitted disease, STD, venereal disease, VD, Donovan bodies, donovanosis, genital lesions, Calymmatobacterium granulomatis, C granulomatis, Klebsiella granulomatis, Donovania granulomatis, K granulomatis, D granulomatis

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Background

Granuloma inguinale (GI) is primarily a sexually transmitted disease in which characteristic intracellular inclusions called Donovan bodies may be seen. It usually manifests as genital lesions, which are indolent, progressive, ulcerative, and granulomatous.

Pathophysiology

GI is caused by the gram-negative pleomorphic bacillus Klebsiella granulomatis, which is formerly known as Calymmatobacterium granulomatis or Donovania granulomatis. The mode of transmission is primarily through sexual contact, although GI may be obtained through a fecal route or by passage through an infected birth canal. It is considered to be only mildly contagious, and repeated exposure may be necessary for clinical infection to occur.

Frequency

United States

Fewer than 100 cases are reported annually, many of which are thought to be due to foreign travel.

International

GI is endemic in Western New Guinea, the Caribbean, Southern India, South Africa, Southeast Asia, Australia, and Brazil.

Mortality/Morbidity

Untreated, the disease will most likely not remit, and the lesions may continue to expand for years (see Complications).

Race

The racial predilection is most likely due to socioeconomic status and living conditions rather than a racial susceptibility.

  • The incidence is higher in blacks than in whites in the United States.
  • The incidence is higher in natives than in Europeans in Western New Guinea.
  • The incidence is higher in Hindus than in Moslems in India.

Sex

No sexual predominance exists.

Age

The highest incidence occurs in persons aged 20-40 years.

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