Donovanosis general

Question 1

What is donovanosis also known as

Answer 1

Granuloma Inguinale

Question 2

Most likely places to have donovanosis

Answer 2

• India
• Papua New Guinea
• Caribbean
• Brazil
• The Guyanas
• South Africa
• Zambia
• Vietnam
• Australian aboriginals.

Question 3

Organism responsible for Donovanosis

Answer 3

Calymmatobacterium granulomatis officially redesignated Klebsiella granulomatis

Question 4

Clinical features of Donovanosis

Answer 4

• At site of primary inoculation: one or more papules/nodules developing into friable ulcers or hypertrophic lesions which gradually increase in size. Lesions tend not to be painful.
• Regional lymph nodes: initially swelling of the nodes, followed particularly in case of inguinal nodes, by spread of infection into overlying tissues, resulting in either abscess formation (pseudobubo) or ulceration of the overlying skin
• Untreated infections may either resolve spontaneously or persist and slowly spread.

Question 5

Complications of Donovanosis

Answer 5

• Haemorrhage
• Genital lymphoedema
• Genital mutilation and cicatrisation
• Development of squamous carcinoma
• Haematogenous dissemination to bone and viscera, especially in pregnancy

Question 6

Diagnosis of Donovanosis

Answer 6

• Cellular material taken by scraping/impression
  smear/swab/crushing of pinched off tissue fragment on to glass slide
• Tissue sample collected by biopsy
• Smears can be stained with Giemsa, Wright’s stain, or Leishman stain.
• Biopsies are best stained with silver stains (for example, Warthin-Stary) or Giemsa

Question 7

Donovan bodies

Answer 7

• Location within large (20-90 μm) histiocytes,
• Pleomorphic appearance 1- 2 x 0.5-0.7 μm
• Bipolar densities and a capsule often visible
• Stain Gram negative

Question 8

Tx for Donovanosis

Answer 8

• 3 weeks

- Usual for STI