Granuloma Inguinale Research Articles

A retrospective study of the pattern of sexually transmitted infections during a five-year period at tertiary care hospital in Central India.

Abstract Background: Knowledge about the current patterns and trend of sexually transmitted infections (STIs) in different geographical regions is necessary for proper implementation of control measures. Aim: To study the pattern and trend of STIs during a five-year period (2013-17) among patients attending Department of Dermatology, Venereology, and Leprology, Government Medical College and Hospital, Nagpur. Material and methods: Case records of 4552 patients with STIs who attended the Department of Dermatology, Venereology, and Leprology, Government Medical College, Nagpur for five years, from January 2013 to October 2017 were analysed in this retrospective study. Cases had been diagnosed based on the clinical presentation and relevant investigations. Results: Most common age group affected was 31-40 years (34.84%). Balanoposthitis was most common STI in (37.98%) followed by cervicovaginal discharge (30.07%), herpes genitalis (18.65%), molluscum contagiosum (8.26%), condylomata acuminata (1.43%), chancroid (1.43%), genital scabies (1.03%), syphilis (0.63%), urethral discharge (0.48%) and granuloma inguinale (0.11%). About 2.37% cases were human immunodeficiency virus (HIV) positive. Herpes genitalis (46.29%) was the most common STIs in HIV positive patients. Venereal disease research laboratory (VDRL) test was reactive in 0.63% patients. Conclusions: Study concluded that bacterial STIs like syphilis (0.63%), chancroid (1.43%) and granuloma inguinale (0.11%) were less common then viral STIs. The infection rate of syphilis and chancroid has increase dramatically in recent years. Viral STIs were more likely to be associated with HIV than bacterial infections. Balanoposthitis, cervicovaginal discharge and herpes genitalis constitute the major burden of STIs clinic. Key words: sexually transmitted infections, viral, bacterial, HIV

An Overview of Sexually Transmitted Diseases

Physically sent sicknesses are a tireless issue in the United States and all through the world. A significant number of these diseases include the skin and might be experienced in the field of dermatology. This 3-section survey features the cutaneous highlights, analysis, and treatment of 11 of the most regularly experienced physically communicated sicknesses, other than AIDS. Notwithstanding, this audit doesn't cover physically communicated sicknesses like chlamydia, which don't consistently have cutaneous appearances. Section 1 spotlights on syphilis, dispersed gonococcal disease, chancroid, lymphogranuloma venereum, granuloma inguinale, and genital herpes. Extra highlights, like the study of disease transmission and transmission of the living being, are examined when material.

Nonsexual Transmission of Sexually Transmitted Diseases

Explicitly communicated illnesses happen in pestilence numbers in the United States today. Nonsexual transmission of these illnesses is seldom an issue in grown-ups. Nonetheless, when similar sicknesses are found in youngsters, the inclination of pediatrician's and other medical services experts has been to accept the method of transmission is agamic. A survey of gonorrhea, Chlamydia trachomatis, herpes genital is, condyloma acuminata, Trichomonas vaginalis, syphilis, chancroid, and granuloma inguinale contaminations has been made to address the issue of nonsexual transmission of explicitly sent illnesses. Nonsexual transmission of these diseases is an inconsistent event and when they influence the prepubertal youngster, sexual maltreatment should be profoundly suspected.

Amoebiasis of the Penis: A Review and Update

Ulceration of the penis/foreskin which would tend to be painful, Swelling of the penis, Oedema of the penis, Discharge from ulcer or inflamed area of penis that could be purulent or may contain blood, Balanoposthitis, Exudation from a penile ulcer which could be mild, profuse, purulent or bloody, Sloughing off of part of the foreskin and other tissues with resulting hypospadias, indurated swelling of the penis which may initially involve one part of the penis but could quickly spread, A history of homosexual coital activity may be obtained, The spouse of a man who has Amoebiasis of the penis could also have Amoebiasis of vulva, cervix or endometrium, The prepuce may not be retractable, There may be ulceration or swelling of the glans penis that may be irregular. Clinical examination findings in cases of Amoebiasis of the penis could reveal some of the ensuing: The general and systematic examinations may be normal. Examination of the penis may show: Tight non-retractile foreskin, Ulceration of foreskin, Swelling of the foreskin, Swelling of the glans penis, Ulceration and swelling of glans penis., Swelling and inflammation of the shaft of the penis, Ulceration on the shaft of the penis, Development of an iatrogenic hypospadias which was not there before, The inguinal lymph nodes may not be palpable but sometimes they may be enlarged on one side or on both sides, The penile swelling may involve part of the penis but at times on rare occasions the entire penis may be swollen, the penile swelling could on rare occasions extend to the supra-pubic area, On rare occasions the swelling of the penis could extend to include the scrotum but this is extremely rare. Amoebiasis of the penis does mimic various common conditions that affect the penis including: squamous cell carcinoma of the penis, chancroid, primary syphilitic ulcer of the penis, granuloma inguinale, balanoposthitis, and many other lesions affecting the penis. A high-index of suspicion is required to diagnose Amoebiasis of the penis. Clinicians need to be aware that male homosexuals who practice penetrative penis-anal coital activity have a higher risk of developing amoebiasis of the penis especially in Amoebiasis endemic countries. If an individual is suspected to have balanoposthitis or non-specific infection of the penis and is treated with antibiotics but the lesion does not respond to treatment, amoebiasis of the penis should be suspected. Secretions and discharges from the penile ulcer as well as biopsies of the penile lesion should be submitted for pathology examination which would demonstrate trophozoites, entamoebae as well as inflammatory cells. Even if carcinoma of the penis is initially suspected biopsy of the penile lesion would show features of Amoebiasis in the absence of any features of malignancy but in the very rare situation of a combination of Amoebiasis of the penis and carcinoma of the penis microscopic pathology examination of a biopsy specimen of the penile lesion would show features of Amoebiasis and carcinoma of the penis. .Amoebiasis of the penis does quickly and effectively respond to anti-amoebic medicaments.

Sexually Transmitted Infections

Sexually transmitted infections (STI’s) are relatively common. Their presentations range from symptom-free to highly painful, debilitating and life-threatening. The approach to each type of infection varies, and depends on the ability to screen, the availability and effectiveness of treatment, and the likelihood of long-term sequelae. For many infections, prophylaxis is possible; other infections are more challenging to prevent. Unless sexual partners are also treated, re-infection is a concern, as is the further spread of disease to subsequent sexual contacts. Some infections, once effectively treated, lead to an asymptomatic carrier state that may or may not re-emerge as an active problem and/or cause sexual contacts to become ill. This review contains 10 tables, and 44 references. Key Words: sexually transmitted infections, chlamydia, gonorrhea, syphilis, HIV, herpes simplex, granuloma inguinale, lymphogranuloma venereum, chancroid, trichomoniasis

Sexually transmitted infections and human immunodeficiency virus coinfection: Scenario in Western India.

Context:Sexually transmitted infections (STIs) have a well-established synergistic relationship with human immunodeficiency virus (HIV) infection. Coinfection with HIV and STI can increase the probability of HIV transmission to an uninfected partner by increasing HIV concentrations in genital lesions, genital secretions, or both. Concurrent HIV infection alters the natural history of the classic STIs.Aims:The aim was to study the current scenario of STIs with HIV co-infection, and to recognize different manifestations of STIs than the classical presentation in people living with HIV/AIDS (PLHIV).Settings and Design:It was an open, cross-sectional, descriptive study carried out in the setting of state government hospital with attached antiretroviral therapy referral center.Subjects and Methods:The sample size of the study was duration based (30 months).Inclusion Criteria:All PLHIV presenting to the department of dermatology with STIs were included in the study.Exclusion Criteria:Non-STI causes of genital ulceration were excluded in the study.Results:The study includes total (n = 484) patients living with HIV/AIDS, prevalence of different STIs was in the following order, herpes simplex virus infections 24.17%, human papillomavirus infections 8.88%, molluscum contagiosum 7.43%, secondary syphilis 4.33%, gonorrhea 1.85%, chancroid 1.44%, and granuloma inguinale 0.41%. Of all the patients with herpes simplex virus infections, 45.6% (n = 57) had multiple recurrences (>6/year). The incidence of mixed STI was 17.29% in the present study.Conclusions:The study represents decreasing trends in bacterial STIs and the rise of viral STIs. Atypical presentations of classic STIs were more frequent than non-HIV-infected individuals.

A study of clinical course and therapeutic response of sexually transmitted infections in people living with HIV/AIDS

<p class="abstract"><strong>Background:</strong> Human immunodeficiency virus (HIV) continues to be a major public health problem worldwide. Once a person is infected with HIV, the manifestations of other infections and diseases are altered due to waning of the host immunity.</p><p class="abstract"><strong>Methods:</strong> This study was carried out in HIV reactive patients in Command Hospital, Pune. The types of sexually transmitted infections (STIs) in those patients and the response to therapy were studied in detail. The statistical data was expressed as number and percentages.<strong></strong></p><p class="abstract"><strong>Results:</strong> In this study, 52 people living with HIV/AIDS (PLWHA) who were having various STIs were included. Majority of the patients in this study belonged to the age group of 20-34 years (75%). The most common STIs encountered were condyloma acuminata (38.45%) followed by syphilis (30.77%), lymphogranuloma venereum, herpes genitalis, chancroid, molluscum contagiosum, gonorrhea and granuloma inguinale. Resistance to antimicrobial therapy at the standard dosage, requirement of higher dosage, resistance and relapse of infections were observed in the patients with PLWH.</p><p class="abstract"><strong>Conclusions:</strong> Several STIs coexisted with HIV infected patients. Unusual clinical presentations, clinical course and treatment failure in STI were common in HIV infected individuals. Hence all STI patients should be screened for HIV and vice-versa.</p>

Sexually Transmitted Infections in the Tropics

Sexually transmitted infections (STI) are common all over the world and the incidence of chlamydia, gonorrhea, syphilis and trichomoniasis alone is estimated at 500 million/year. Of these infections 75% occur in tropical countries in Latin America, sub-Saharan Africa and South as well as Southeast Asia. The bacterial infections chancroid, lymphogranuloma venereum (LGV) and granuloma inguinale (GI, Donovanosis) are termed tropical STI. They occur mainly in tropical countries, i. e. regions situated between the equator and the northern and southern 23.5° latitudes, regions which are characterized by hot humid climates as well as poverty and underdevelopment. These three diseases are primarily associated with ulcerations of the skin, thus their presence represents an increased risk for transmission of HIV and other STI. As with all STI, to minimize the risk of tropical infections it is essential to avoid hazardous sexual practices and to use condoms.

Donovanosis in a child victim of sexual abuse: response to doxycycline treatment

Donovanosis is a chronic infectious disease caused by the Gram-negative bacteria Klebsiella granulomatis, which mainly affects the skin and mucous membranes of the genital, perigenital, and inguinal regions. Also known as venereal granuloma or granuloma inguinale, it is endemic in tropical and subtropical regions of the globe and often associated with sexual transmission. We report the case of an 11-year-old female victim of chronic sexual abuse, who was diagnosed with donovanosis and presented a good therapeutic response to doxycycline.

Usefulness and Utility of NACO Regime in the Management of Sexually Transmitted Infections: A Pilot Study.

Introduction:Treatment of sexually transmitted infections (STIs) has been made easy for field workers due to syndromic approach. The etiological agent responsible for different STI syndromes needs to be validated from time to time so as to guide the therapeutic regimen.Aims and Objectives:The aim of this study was to evaluate the etiological agent for STI syndromes and correlate the syndromic diagnosis with etiological diagnosis.Materials and Methods:The study was conducted over 9 months in all patients attending the STI and Gynaecology Outpatient Department. Syndromic diagnosis was done by STI-trained medical officer of respective clinic. Sample was collected for etiological diagnosis and subjected to relevant investigations. Data were analyzed by applying statistical methods.Results:Among 308 patients (male:female = 1:3.5), no syndromic diagnosis could be made in 11 cases (all females and had premalignant changes on Pap smear). In 68 patients (22.08%), no etiological diagnosis could be arrived at (mostly genital ulcer disease [GUD]-herpetic [H] and vaginal discharge). In cervical discharge syndrome, six patients (16.7%) showed gonococcus. In GUD-H syndrome, 37 patients (27.027%) were tested positive. In GUD-nonherpetic syndrome, three patients (33.33%) were syphilis, granuloma inguinale, and chancroid (1 each). In urethral discharge syndrome, etiology could not be found in 33 cases (45.45%). In vaginal discharge syndrome (n = 217), etiologies were overlapping as follows: trichomonas vaginalis (76.04%), bacterial vaginosis (40%), gonococcus (24%), and undiagnosed (6.5%).Conclusion:The present tool for validation of GUD-H can validate only 27% of cases. Overlap of etiologies is mostly common in vaginal discharge syndrome, wherein malignancies and premalignant conditions are overtreated with kits. Validation can be done only in two-third of cases with the available resources. However, syndromic approach provides the opportunity of treating STI without delay.

Granulomatous & histiocytic dermatitides.

Granulomas of the skin may be classified in several ways. They are either infectious or non-infectious in character, and they contain areas of necrobiosis or necrosis, or not. Responsible infectious agents may be mycobacterial, fungal, treponemal, or parasitic organisms, and each case of granulomatous dermatitis should be assessed histochemically for those microbes. In the non-infectious group, examples of necrobiotic or necrotizing granulomas include granuloma annulare; necrobiosis lipoidica; rheumatoid nodule; and lupus miliaris disseminates faciei. Non-necrobiotic/necrotizing and non-infectious lesions are exemplified by sarcoidosis; foreign-body reactions; Melkersson-Rosenthal syndrome; Blau syndrome; elastolytic granuloma; lichenoid and granulomatous dermatitis; interstitial granulomatous dermatitis; cutaneous involvement by Crohn disease; granulomatous rosacea; and granulomatous pigmented purpura. Histiocytic dermatitides that do not feature granuloma formation are peculiar reactions to infection, such as cutaneous malakoplakia; leishmaniasis; histoplasmosis; lepromatous leprosy; rhinoscleroma; lymphogranuloma venereum; and granuloma inguinale.

Donovanose contractée en France

Donovanosis (granuloma inguinale) is a bacterial infection caused by Klebsiella granulomatis that occurs mainly in the genital area and is primarily sexually transmitted; it is seen predominantly in the tropics. Herein, we report a case of the disease contracted in metropolitan France. A 47-year-old man presented with painless ulceration of the glans, present for one month, with progressive extension; there was no history of any recent trip abroad. Skin biopsy with Whartin-Starry and Giemsa staining revealed Donovan bodies in the cytoplasm of macrophages. Based on these findings, further questioning of the patient revealed unprotected sexual contact two months earlier in France. Treatment was initiated with azithromycin 1g on the first day followed by 500mg per day for three weeks. The clinical outcome was spectacular, with almost complete regression of the ulcer at 7 days. This case demonstrates that donovanosis can occur in metropolitan France.

Granuloma inguinale in a 51-year-old man

Granuloma inguinale, or Donovanosis, is a rare, sexually transmitted ulcerative disease primarily affecting the genital area. In this report, we present a case of a 50-year-old man that was diagnosed with granuloma inguinale after a 2-month history of a penile ulcer. Histological analysis demonstrated the presence of Donovan bodies within macrophages, confirming the diagnosis. He was subsequently treated with trimethoprim/sulfamethoxazole with improvement in the ulcer. This case serves as a reminder to clinicians that although granuloma inguinale is rarely encountered in the US, it should still be suspected in patients with non-healing penile ulcers.

Travel-related sexually transmitted infections.

Sexually transmitted infections (STIs) are among the most common notifiable health problems worldwide, with particularly high rates in developing countries. Men and women with multiple sexual partners at home or a previous history of STIs are more likely to have casual sexual exposure (CSE) while travelling. Over the last several decades 5% to even 50% of short-term travellers engaged in CSE during foreign trips. It is estimated that only 50% of travellers use condoms during casual sex abroad. Sexual contact with commercial sex workers is an exceptionally high-risk behaviour. The common risk factor is also young age. Adolescents and young adults constitute 25% of the sexually active population, but represent almost 50% of all new acquired STIs. Many STIs are asymptomatic and therefore can be difficult to identify and control. The clinical manifestation of STIs can be grouped into a number of syndromes, such as genital ulcer or erosion, urethral or vaginal discharge, pelvic inflammatory disease. STIs are divided into curable infections caused by bacteria (gonorrhoea, chlamydiasis, syphilis, chancroid, lymphogranuloma venereum, granuloma inguinale) or protozoa (trichomoniasis) and incurable viral infections (genital herpes, genital warts, HIV). STIs are not only a cause of acute morbidity, but may result in complications including male and female infertility, ectopic pregnancy, cervical cancer, premature mortality or miscarriage. Monogamous sex with a stable, uninfected partner or sexual abstinence remains the only way to avoid the risk of becoming infected with STIs.

Úlcera genital por Klebsiella granulomatis (Donovanosis) en una pareja heterosexual

SUMMARY Background: The Donovanosis or granuloma inguinale is an infectious, chronic inflammatory and usually ulcerative disease, preferentially of anogenital location, that is sexually transmitted and caused by the bacteria Klebsiella granulomatis. It is characterized by the presence of the Donovan bodies in the microscopy of the secretion of the ulcers. The objective is to present a case of Donovanosis in a heterosexual couple, who consulted by the simultaneous presence of an injury in the vulva and penis. Case record: Couple of a 21 year-old woman and a 24 year-old man of high socioeconomic level that observed simultaneously the apparition of a painless and ulcerated injury of elevated edge and clear base, as much in the labia majora of the vulva as in the body of the penis. They denied the practice of anal coitus or promiscuity. The Donovanosis was suspected and the cytological study of the secretion of the injury was carried out. The Donovan bodies were found in the injury of the woman with the Giemsa stain. The sample of the man was insufficient for the study. The treatment of the couple was done with Doxycycline. The man had complete improvement but the woman presented recurrence for what Azithromycin was added to the treatment. To the four months of the diagnosis, both of them were asymptomatic and they had a small area of scar.

Deep Fungal Infections, Blastomycosis-Like Pyoderma, and Granulomatous Sexually Transmitted Infections.

Granulomatous diseases are caused by multiple infectious and noninfectious causes. Deep fungal infections can present in the skin or extracutaneously, most commonly with lung manifestations. An Azole or amphotericin B is the universal treatment. Blastomycosis-like pyoderma is a clinically similar condition, which is caused by a combination of hypersensitivity and immunosuppression. Successful treatment has been reported with antibiotics and, more recently, the vitamin A analog, acitretin. Granuloma inguinale and lymphogranuloma venereum cause ulcerative genital lesions with a granulomatous appearance on histology. The Centers for Disease Control and Prevention recommens treatment of these genital infections with doxycycline.

Tuberculosis of the Penis: A Review of the Literature.

Background. Tuberculosis of the penis (TBP) is rare. Aim. To review the literature. Method. Various internet data bases were searched. Literature Review. TBP could be primary or secondary, may develop following circumcision performed by a person who had pulmonary Tb, and may be transmitted to the penis from ejaculation, contamination from clothing, or from contact with endometrial secretions, following an earlier pulmonary Tb or Tb elsewhere. TBP presents with a painless/painful small nodule, ulcer, mass on penis which gradually enlarges, and induration/swelling of penis, with or without erectile dysfunction. Inguinal lymph nodes may or may not be palpable. The patient's voiding is normal. There may or may not be history of circumcision, pulmonary Tb, and BCG immunization. TBP mimics penile carcinoma, granulomatous syphilis penile ulcer, genital herpes simplex, granuloma inguinale, and HIV infection. Diagnosis is established by microscopic examination finding of granulomas +/−AFB in penile discharge or biopsy of lesion or culture of Tb organism from discharge or biopsy specimens or positive Elisa serology/PCR for Tb. PTBs respond to first- or 2nd-line anti-Tb 6-month treatment. Close contacts should be screened. Extrapulmonary Tb should be excluded. Conclusions. Clinicians should consider possibility of PTB in cases of penile lesions and erectile failure.

Vulval Elephantiasis Secondary to Tubercular Lymphadenitis

Abstract Background: Elephantiasis as a result of chronic lymphedema is characterized by gross enlargement of the arms, legs, or genitalia, and occurs because of the presence of various obstructive diseases of the lymphatic system. Commonly, genital elephantiasis follows filariasis and lymphogranuloma venereum. Genital elephantiasis may also follow granuloma inguinale, carcinomas, lymph-node dissection or irradiation, and tuberculosis, but this happens rarely. Vulval elephantiasis as a consequence of extensive lymph-node destruction by tuberculosis is very rare. This article presents a very unusual case of vulval elephantiasis caused by tuberculous destruction of the inguinal lymph nodes. Case: A 30-year-old Indian woman had progressively increasing vulval swelling for 5 years' duration. This patient had a history that was significant because she had undergone a complete course of antitubercular treatment for inguinal lymphadenopathy. Her vulval swellings were extremely large—20×15 cm on the left side and...

Granuloma inguinal (Donovanosis) de la encía y regiones submandibulares

El granuloma inguinal (Donovanosis) de la cavidad oral es muy raro, sin embargo representa lamanifestación extragenital mas frecuente de esta infección producida por la bacteria gramnegativa Calymmatobacterium granulomatis. Se describe un caso de donovanosis gingival en unhombre homosexual de 19 años de edad. Las lesiones gingivales se presentaron como úlcerasmicrogranulomatosas combinadas con zonas esponjosas. El paciente también tenía lesiones enlas regiones submandibulares y perianal. El diagnóstico se estableció por biopsia gingival. Eneste tejido, las secciones teñidas con hematoxilina - eosina mostraron una marcada reaccióngranulomatosa compuesta por histiocitos, mezclados con abundante cantidad de neutrófilos ypocas células plasmática. Los cuerpos de Donovan fueron identificados usando la coloración deWarthin-Starry . Se discute el diagnóstico clínico diferencial así como el cuadro histopatológico.Considerando el comportamiento sexual del paciente se sugiere que el compromiso gingival ysubmaxilar probablemente representaban múltiples sitios primarios de infección porC.granulomatis. Sin embargo, la autoinoculación no puede ser descartada. Donovanosis debe serconsiderado en el diagnóstico diferencial de lesiones granulomatosas que afectan la mucosa oral,particularmente cuando se presentan en pacientes promiscuos.

Sexually transmitted infections.

In no other medical field former rare infections of the 1980(th) and 1990(th) occur again as this is seen in the field of venerology which is as well based on the mobility of the population. Increasing rates of infections in Europe, and increasing bacteriological resistances face health professionals with new challenges. The WHO estimates more than 340 million cases of illnesses worldwide every year. Diseases caused by sexually transmitted infections (STI) in a strict sense are syphilis, gonorrhea, lymphogranuloma venereum, granuloma inguinale, and chancroid. In a wider sense, all illnesses are included which can mainly be transmitted through sexual contact. The term "sexual contact" has to be seen widely, from close physical contact to all variants of sexual behavior. This CME article is an overview of the most common occurring sexually transmitted infections in clinical practice. Both, basic knowledge as well as recent developments are discussed below.