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Granuloma inguinaleDefinition Granuloma inguinale is a sexually-transmitted disease that is rarely seen in the United States. It causes surface destruction and granuloma formation in the skin and subcutaneous tissue. Causes, incidence, and risk factors Granuloma inguinale is a bacterial disease caused by the organism Calymmatobacterium granulomatis. The disease is commonly found in tropical and subtropical areas such as Southeast India, Guyana, and New Guinea, but it occurs on occasion in the United States, typically in the Southeast. There are approximately 100 cases reported per year in the United States. Men are affected more than twice as often as women, with most infections occuring in people aged 20-40 years. The disease is seldom seen in children or the elderly. It is thought that anal intercourse, rather than vaginal intercourse, is the most frequent source of infection. About 50% of infected men and women have lesions in the anal area. Symptoms
In its early stages, it may be difficult to differentiate granuloma inguinale from chancroid. In the later stages, granuloma inguinale may resemble advanced genital cancers, lymphogranuloma venereum, and anogenital cutaneous amebiasis. Signs and tests Classically, the diagnosis of granuloma inguinale should be considered if genital lesions have been present for a long time and have been progressively enlarging. Serological tests such as that used to detect syphilis are available only on a research basis for diagnosing granuloma inguinale. Tests that may be performed include:
Treatment A complete cure of granuloma inguinale requires fairly long treatment. Most treatment courses run 3 weeks or until the lesions have completely healed. The antibiotics used include:
Expectations (prognosis) Treating this disease early decreases the chances of tissue destruction or scarring. Untreated disease can lead to complications. Complications
Calling your health care provider Call for an appointment with your health care provider if you have had sexual exposure to a person who is known to have granuloma inguinale, or if you develop symptoms similar to those listed above. Prevention Safe sex practices will prevent the spread of granuloma inguinale, as well as other sexually-transmitted diseases. Sexual contact with people living in tropical and subtropical climates increases the likelihood of exposure. References Keck JW. Ulcerative Lesions. Clin Fam Pract. 2005 Mar; 7(1); 13-30. Rackel RE, Bope ET. Granuloma Inguinale. In: Conn's Current Therapy 2005. 57th ed. St. Louis, MO: Saunders; 2005:859. Illustrations
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