What Is Granuloma Inguinale?
Granuloma inguinale is a sexually transmitted infection
(STI). This STI causes lesions in the anal and genital regions. These lesions can
recur, even after treatment.
Granuloma inguinale is sometimes called “donovanosis.”
The Symptoms and Stages of Granuloma Inguinale
Signs of the condition have a slow onset. It usually takes
at least one week to experience symptoms. It can take up to 12 weeks for
symptoms to reach their peak.
Generally, you will first experience a pimple or a lump on
your skin. This blemish is small and not typically painful, so you may not
notice it at first. The infection often begins in the genital region. Anal or
mouth sores occur only in a minority of instances, and only if the sexual
contact involved these areas.
The skin lesion progresses through three stages:
In the first stage, the small pimple will begin to spread
and eat away at the surrounding tissue. As the tissue begins to wear away, it turns
pink or a faint red. The bumps then turn into raised red nodules with a velvety
texture. This happens around the anus and genitals. Although the bumps are
painless, they can bleed if they are injured.
In the second stage of the disease, bacteria begin to erode
the skin. Once this occurs, you will develop shallow ulcers that will spread
from the genitals and anus to the thighs and lower abdomen, or inguinal area.
You will notice that the perimeters of the ulcers are lined with granulated
tissue. A foul smell may accompany the ulcers.
When granuloma inguinale advances to the third stage, the
ulcers become deep and morph into scar tissue.
What Causes Granuloma Inguinale?
A class of bacteria known as Klebsiella granulomatis causes
this infection. Granuloma inguinale is an STI, and you can contract it by
having vaginal or anal intercourse with an infected partner. In rare instances,
it can be contracted through oral sex.
Who Is at Risk for Granuloma Inguinale?
You put yourself at risk if you have sexual contact with
individuals from the tropical and subtropical regions where the disease is most
prevalent. Males are twice as likely to acquire granuloma inguinale as women.
As a result, homosexual men have a greater likelihood of getting granuloma
inguinale. Individuals who are between the ages of 20 and 40 contract the
condition more often than those in other age groups.
Where you live plays a role in determining your risk of
infection. For instance, if you live in the United States and are infected, it
is usually because you had sexual contact with someone who lives abroad.
Tropical and subtropical climates are the most likely areas
where people encounter granuloma inguinale. The disease is endemic in:
- New Guinea
- Southeast India
- parts of Australia
A higher number of cases are also reported in parts of
Brazil and South Africa.
How Is Granuloma Inguinale Diagnosed?
Granuloma inguinale can be difficult to detect in the early
stages, since you may not notice the initial lesions. Your doctor will usually
not suspect granuloma inguinale unless ulcers have begun to form and do not
If the ulcers do not heal after a prolonged period of time,
your doctor may order a skin biopsy of the lesions. This will probably be
performed as a punch biopsy. When you undergo a punch biopsy, your doctor will
remove a small area of the ulcer with a circular blade. Once removed, the
sample will be tested for the presence of Klebsiella granulomatis bacteria.
It may also be possible to detect bacteria by scraping some of the lesion and
conducting further tests on the sample.
Since having granuloma inguinale is know to raise your risk
for other sexually transmitted diseases (STDs), you may be given blood tests or
have other diagnostic testing or cultures taken to check for those as well.
Treatment for Granuloma Inguinale
Granuloma inguinale can be treated using antibiotics like tetracycline
and the macrolide erythromycin.
Streptomycin and ampicillin
may also be used. Most treatments are prescribed for three weeks, although they
will continue until the infection is cured.
Early treatment is advised to prevent permanent scarring and
swelling in the genital, anal, and inguinal areas.
After you have been treated, you need to have routine
examinations to ensure that the infection does not come back. In some cases, it
recurs after it seems to have been cured.
What Is the Outlook for Granuloma Inguinale?
Granuloma inguinale is treated with antibiotics. If the
infection isn’t treated, it will spread to the lymph nodes in the groin area.
This will make it more likely that you will experience recurring infections
after you have finished treatment.
You should let all of your sex partners know that you have
this infection. They will need to get tested and treated. After your treatment
is finished, you should see your doctor once every six months. Your doctor will
make sure the condition hasn’t recurred.