Diagnosis Of Granuloma Inguinale Research Articles

Cutaneous Metastases of Rectal Mucinous Adenocarcinoma Mimicking Granuloma Inguinale

A 46-year-old man complained of ulcerovegetative lesions in the anogenital region, which he had noted one month prior to presentation. The patient had a history of travel to African countries. Therefore, the ulcerovegetative lesions of the patient were suspected to be granuloma inguinale (GI). Calymmatobacterium granulomatis was not observed in the direct examination of scrapings collected from the base of the ulcerovegetative lesion. Instead, a histological examination revealed cutaneous metastasis of mucinous adenocarcinoma of the rectum. Therefore, a diagnosis of GI was eliminated. As the patient did not report his history of rectal cancer and had travelled to African countries, we had primarily focused on the diagnosis of GI.

Granuloma inguinale in association with pregnancy and HIV infection

Objectives: A retrospective study to confirm the clinical impression of an increasing prevalence of granuloma inguinale (GI) in women, and to evaluate its association with pregnancy and HIV infection. Methods: Clinical records of all patients with a definitive diagnosis of GI attending the gynecology and antenatal clinics at King Edward VIII Hospital, Durban, South Africa, over a period of 36 months (January 1991–December 1993). Results: A total of 123 women were diagnosed with GI. The diagnosis was made by tissue smear alone in 21% ( n = 26), histology 43% ( n = 53) and by a combination of smear and histology in the rest. Forty-two percent ( n = 52) were pregnant. The only difference between pregnant and non-pregnant women were the presence of rectal and pelvic lesions in the latter. Sixty-nine percent ( n = 36) delivered vaginally while the remaining ( n = 16) were delivered by cesarean section. The indications for cesarean section were obstetric except for a patient in labor with extensive untreated vulval granuloma. In the majority (85%) GI had no influence on pregnancy outcome. There was no evidence of congenital GI in the neonates. Twenty-seven percent ( 30 113 ) had positive syphilis serology and 16% ( 18 110 ) had antibody to HIV. There were no differences in the clinical features and outcome of HIV positive and negative women. Conclusion: This study shows that GI is increasing in pregnancy in Durban, South Africa. Despite the concern that pregnancy promotes dissemination of GI, such an effect could not be established as the clinical response to treatment and outcome were similar in both pregnant and non-pregnant women. Infection with HIV also did not alter the clinical presentation and outcome of the disease in the patients studied.

A rapid stain for the diagnosis of granuloma inguinale.

Tissue smears were prepared from 55 men and eight women with genital ulceration using two staining techniques and examined by direct microscopy for the presence of Donovan bodies. Twenty three smears were positive using the May-Grunwald-Giemsa staining method and 23 were positive using a rapid technique, the RapiDiff stain. The RapiDiff technique is suitable for use in the diagnosis of granuloma inguinale (donovanosis) in busy sexually transmitted diseases clinics in the developing world.

A rapid stain for the diagnosis of granuloma inguinale.

Tissue smears were prepared from 55 men and eight women with genital ulceration using two staining techniques and examined by direct microscopy for the presence of Donovan bodies. Twenty three smears were positive using the May-Grunwald-Giemsa staining method and 23 were positive using a rapid technique, the RapiDiff stain. The RapiDiff technique is suitable for use in the diagnosis of granuloma inguinale (donovanosis) in busy sexually transmitted diseases clinics in the developing world.

GRANULOMA INGUINALE IN NORTHERN QUEENSLAND

Thirteen cases of granuloma inguinale were diagnosed in just over a twelve-month period at the Australian Government Health Laboratory and the General Hospital, Townsville. Seven patients were males, four of whom were immates of Her Majesty's Prison, Townsville. Two of the patients were married, and two were sisters. All the female patients were pregnant at the time of diagnosis. The provisional diagnosis was confirmed by the presence of intracytoplasmic Donovan bodies in crushed tissue smears stained with Wright's stain and pinacyanole. The diagnosis of granuloma inguinale could not be reliably made from sections of formalin-fixed tissue alone. The clinical findings, methods of laboratory diagnosis, management and treatment of this disease are also described with an added emphasis on treatment during pregnancy.

Granuloma Inguinale

A 20-year-old woman developed bleeding because of a painless genital ulcer. The diagnosis of granuloma inguinale was proven by showing the presence of Donovan bodies in a biopsy of the lesion. Treatment with tetracycline was successful when given in adequate dosage. Granuloma inguinale, although rare, should be considered in the differential diagnosis of patients with asymptomatic genital ulcers. Multiple biopsies may have to be done and stained with fresh Giemsa to prove the diagnosis, as in this case.

An intradermal reaction as an aid in the diagnosis of granuloma inguinale: Kornblith, B. A.: New York State J. Med. 44: 2476, 1944

An intradermal reaction as an aid in the diagnosis of granuloma inguinale: Kornblith, B. A.: New York State J. Med. 44: 2476, 1944