Granuloma Inguinale Research Articles

Treatment of granuloma inguinale with triacetyloleandomycin. Report of a case.

Granuloma inguinale (granuloma venereum, donovanosis), a disease of the skin and subcutaneous tissues, usually of the genital region, and seen mainly among the darkskinned races, is still endemic in some parts of the world including southern United States. The etiology, epidemiology, diagnosis, differential diagnosis, and clinical course have been well reviewed by Greenblatt and associates 1 and Thambiah. 2 Penicillin has proved ineffective, and nonspecific treatment has been generally disappointing and punctuated by relapses. Until the advent of streptomycin, dissemination to other parts of the body, with prolonged disability and even death, resulted directly or indirectly from secondary spread of the lesions from the primary focus. Medina and Alarcon 3 reported a fatal case in a white woman of granuloma inguinale with large granulomatous ulcerations on the external genitals, and invasion of vaginal mucosa and uterine cervix. Despite antibiotic treatment, ulcerous lesions on the left leg and an intestinal fistula

Granuloma inguinale with hematogenous dissemination to the spine.

GRANULOMA INGUINALE with metastases to bone is a comparatively rare occurrence. In the United States, primary granuloma inguinale has apparently been on the increase in the last few years as have the other venereal diseases. The placing of granuloma inguinale in the venereal category is actually an arbitrary one, as this condition has never been absolutely proved to be of venereal origin. It is the proclivity of this disease for the genital region that qualifies it to be listed as a venereal infection. In this paper granuloma inguinale and its complications will be reviewed, and a case of this disease with unusual sequelae will be presented. Granuloma inguinale is a chronic granulomatous process that involves the skin and subcutaneous tissue of the genital region. The etiologic agent is the Donovan body. This is an intracellular inclusion body first described by Donovan in 1904. The true nature of the Donovan

Experiences in a Vaginitis Clinic

<h3>To the Editor:—</h3> Dr. Myers' query is specifically concerned with the omission of any mention of the gonococcus as a cause of vaginitis in adults. In our experience, at least with our patient population, "pure" gonococcal vaginitis without involvement elsewhere of the genital tract is very rare. This is in contradistinction to the situation in the prepubertal female in whom gonococcal vulvovaginitis is more often seen. For that reason<i>Neisseria gonorrheae</i>was not mentioned by name in the text dealing with adult vaginitis. In Table 1 it is included under miscellaneous infections, of which there are many, including Vincent's organisms, tuberculosis, granuloma inguinale, various viral infections, etc. By common agreement it is usually not included among so-called "nonspecific" infections. As stated in the article, most of our patients are referred from other clinics where smears and occasionally cultures for the gonococcus may have been obtained. Moreover, we do screen each

Studies on granuloma inguinale. IV. Growth requirements of Donovania granulomatis and its relationship to the natural habitat of the organism.

Studies on granuloma inguinale. IV. Growth requirements of Donovania granulomatis and its relationship to the natural habitat of the organism.

Donovanosis of the anus in the male; an epidemiological consideration.

Donovanosis, also known as granuloma inguinale, granuloma venereum, and by other names (Marmell and Santora, 1950), is a chronic specific infection manifested clinically by ulcerating granulomatous lesions inivolving, in the majority of cases, the skin and subcutaneous tissues. Although these manifestations are generally limited to the genitalia and adjacent areas, the lesions may appear-both as primary sites of infection and as the results of autoinoculation and lymphogenic spread-in other parts of the body, including the viscera and skeleton. The specific agent that causes this disease is Donovania granulomatis, a bacterial organism of distinct morphology, commonly known as the Donovan body. The disease is diagnosed by the demonstration of D. granulomatis in tissue cells from the lesions. Donovanosis is endemic in tropical and subtropical regions, particularly in Asia and the Americas. Although donovanosis has been known as a clinical entity since 1896, the epidemiology of the infection has remained largely without clarification (Rajam and Rangiah, 1954). The incubation period of the naturally acquired infection, the factors involved in racial and individual susceptibility, and the mode of infection and manner of transmission are not established. Whether it is venereal or nonvenereal in nature has been debated from the early history of the disease to the present day. The epidemiological unknowns have led even to the hypothesis that donovanosis may exhibit two different characteristics from the epidemiological point of view: venereal in certain conditons and nonvenereal in others (Forkner, Coats, Grace, Rake, and Speiser, 1955).

Disseminated granuloma inguinale and its relationship to granuloma of the cervix and pregnancy

1. A case is presented of granuloma inguinale disseminated by the hematogenous route.2. To our knowledge this is the first patient with this form of granuloma inguinale successfully treated with tetracycline.3. All previous well-documented case reports were reviewed.4. Thus far, all the patients reported have been females.5. Seven of the 8 patients had known cervical granuloma. The remaining report makes no specific mention of cervical involvement. In only one case is it possible to be certain that pregnancy did not play a part in the hematogenous spread of the disease.6. Severe constitutional symptoms with marked debility and cachexia are serious features of this sometimes fatal disease.

Leukemic ulcer of the penis.

The lesions of leukemia cutis that are usually mentioned in the literature 1 consist of macules, papules, nodules, plaques, subcutaneous tumors, petechiae, and bullae, and they are generally distributed without a definite pattern on any part of the body surface. In addition, ulcerations, both anal and oral, have been described, * but, as far as we can determine, the literature contains no record of a leukemic ulcer of the penis. We herewith report such a case, not only because of its rarity but because of its importance in differential diagnosis. The finding in a young Negro man of an ulcer of the penis associated with regional lymphadenopathy should first suggest the diagnosis of venereal disease and particularly syphilis. Once syphilis is ruled out, there must be eliminated the remaining diseases which may produce penile ulcers: chancroid, herpes progenitalis, lymphogranuloma venereum, granuloma inguinale, epithelioma, erosive balanitis, and mycotic granulomas. At the

Erythromycin in treatment of dermatoses; report on 1,695 patients.

THE INTRODUCTION of each new antibiotic offers a challenge to the clinical investigator to determine its value in the treatment of disease. To effect an impartial evaluation of the antibiotics in the treatment of dermatoses, a team of experienced dermatologists was formed in the Dermatology department at the University of Maryland. Diagnoses were confirmed in most cases by consultation with at least two other members of the team and, where indicated, by laboratory studies. Post-treatment observations were also confirmed by two or more of us. This same procedure had been applied to previously published reports on chlortetracycline (Aureomycin),1oxytetracycline (Terramycin),2and chloramphenicol (Chloromycetin).3In our initial studies, we found erythromycin to be of value in the treatment of granuloma inguinale,4and by local application, in the management of the pyodermas.5 Erythromycin is an antibiotic substance produced by an actinomycete which has

Surgical treatment of genital elephantiasis.

TWO MAJOR types of scrotal elephantiasis, arabum (tropicum) and nostros (nostra) are recognized. 1 Elephantiasis arabum develops secondary to filarial blockage of lymphatics; the nostrum type is sporadic and due to nonfilarial obstruction of lymph drainage from the inguinofemoral areas. Of the latter group, lymphopathia venereum is probably the most frequent cause in this country. Granuloma inguinale, which may not actually be a true venereal disease, 2 is less commonly an etiological agent. 3 Medical treatment is ineffective for long-standing elephantiasis of the genitalia from whatever cause. In both lymphopathia venereum and granuloma inguinale, the maximum value of antibiotic therapy is attained if treatment can be administered early. There has been little published in America on the surgical treatment of scrotal elephantiasis. Hinman 1 depicted a radical surgical removal of the scrotum by Kretchmar and recommended this procedure, to be followed by plastic formation of new penile and scrotal

Granuloma inguinale.

Medical Journal of AustraliaVolume 2, Issue 2 p. 50-52 Original Article GRANULOMA INGUINALE S. D. Watsford, S. D. Watsford Northern Territory Medical Services, Commonwealth Department of HealthSearch for more papers by this authorL. W. Alderman, L. W. Alderman Northern Territory Medical Services, Commonwealth Department of HealthSearch for more papers by this author S. D. Watsford, S. D. Watsford Northern Territory Medical Services, Commonwealth Department of HealthSearch for more papers by this authorL. W. Alderman, L. W. Alderman Northern Territory Medical Services, Commonwealth Department of HealthSearch for more papers by this author First published: 01 July 1953 https://doi.org/10.5694/j.1326-5377.1953.tb94919.xCitations: 8Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article.Citing Literature Volume2, Issue2July 1953Pages 50-52 RelatedInformation

Squamous cell carcinoma of the vulva secondary to granuloma inguinale.

THE CASE to be described is the first in the literature in which the development of carcinoma of the vulva secondary to granuloma inguinale is without doubt. There are in the literature, however, case reports of squamous cell carcinoma of the genitalia that developed at sites previously involved by granuloma inguinale, but none in which this sequence of events can go unquestioned with regard to the vulva itself. REPORT OF A CASE W. G. (No. 38-901), a 16-year-old Negro girl, was admitted to the clinic on Oct. 14, 1938, because of multiple lesions of the vulva of approximately six months' duration. The lesions were granulomatous, beefy red, and covered with a serosanguineous exudate; they involved the fourchette of the vagina, a part of the right vaginal wall, the right labium minus and labium majus, the right genitocrural fold, and in great part the right inguinal region. There were

Neonatal granuloma venereum.

THE PURPOSE of this paper is to report a case of neonatal granuloma venereum in which the causative organism was identified in auricular and postauricular abscesses. Although the distinctive granulomatous lesion has previously been reported in infants, it is understandably rare. It is coincidental that the causative organism in a predominantly venereal disease should have been discovered originally in an extragenital lesion. Donovan,1whose name is given to the specific organism of the disease, in 1905 described minute sporozoa within macrophages in scrapings from a granulomatous lesion in the mouth of a ward boy in the Madras General Hospital. McLeod,2however, had been the first to describe this lesion clinically in a report of three cases of serpiginous ulceration of the scrotum and adjacent structures (1882). Galloway,3in 1897, gave the first microscopic description, but misinterpreted the organisms as granules in the large macrophages. Carter,4independently

Molluscum contagiosum treated with oxytetracycline (terramycin).

Success in the use of oxytetracycline (terramycin) in the treatment of chancroid, lymphogranuloma venereum, and granuloma inguinale, as my associates and I1reported recently, led me to try this agent in a case of molluscum contagiosum, which is considered to be caused by a virus infection. A 5-year-old white boy, when first seen at Temple University Clinic on Dec. 26, 1951, had 92 lesions due to molluscum contagiosum distributed across his back and chest, and new eruptions were appearing. His parents reported that the condition had been present for about nine months. Oral treatment with a suspension of oxytetracycline was begun, 1 teaspoonful (containing 250 mg. of oxytetracycline) four times a day. After four days diarrhea developed, not sufficiently severe, however, to warrant discontinuation of the drug. The dose was reduced to 1 teaspoonful three times a day and continued for 10 days. At the end of that

Granuloma inguinale associated with hepato-splenomegaly and diffuse pulmonary infiltration.

A case of granuloma inguinale superimposed on apparently a visceral sarcoidosis has been reported. The degree of hepato-splenomegaly was considerable, pulmonary pathology was present, and myocardial involvement suspected. Factors in the epidemiology that modify sarcoid development or might possibly give rise to that type reaction from Donovan bodies are emphasized and discussed.

Newer methods in the diagnosis and treatment of granuloma inguinale.

Newer methods in the diagnosis and treatment of granuloma inguinale.

Donovanosis of Tubes and Ovary Treated with Aureomycin and Surgery

Donovanosis of Tubes and Ovary Treated with Aureomycin and Surgery

Comparative study of histology and cytology in vesiculating eruptions.

DIAGNOSTIC aids are continually being sought in dermatology for making differential diagnoses of vesicular diseases. These aids are especially necessary in the differential diagnosis of chronic pemphigus from bullous erythema multiforme and dermatitis herpetiformis, variola from varicella, varicella from herpes zoster disseminata, herpes zoster from herpes simplex, and erythema multiforme bullosum from various forms of vesiculating dermatitis. The cytologic-smear examination, which at present is popular in the field of diagnostic medicine, was used by us in the study of various vesiculating diseases. In the diagnosis of lymphoblastomata, infectious diseases, such as leprosy and granuloma inguinale, and various neoplastic conditions, such as epitheliomas, tissue smears or imprint studies have frequently been used and reported. These preparations have also been used for the differential diagnosis of vesiculating diseases, with questionable value. We have employed this technique, together with the regular histologic preparations, as a comparative study in some of

Podophyllotoxin treatment of Microsporum audouini scalp infections.

THE CLINICAL importance of podophyllotoxin 1 has been an outgrowth of extensive use of podophyllin (podophyllum resin) within recent years. Kaplan 2 in 1942 reported the topical application of podophyllin, the resin obtained from the root of Podophyllum peltatum, to be effective against condyloma acuminatum. Topical use of podophyllin has been found of value also in granuloma inguinale, 3 basal-cell carcinoma, 4 and scalp infections due to Microsporum lanosum and M. audouini. 5 Podophyllin inhibits mitosis and acts as a direct cellular toxin. 6 Sullivan, 7 using chemical, biologic, and pathologic methods, found podophyllotoxin to be the active principle of podophyllin. Podophyllotoxin is a complex tricyclic substance with the formula C 22 H 22 O 8 , and may be inactivated by alkaline hydrolysis in both aqueous and alcoholic solutions. It inhibits the cellular respiration, in vitro, of rat lymph nodes, thymus, kidney tumor, spleen, liver, brain, and testis. 8 The

The treatment of granuloma inguinale, lymphogranuloma venereum, chancroid, and gonorrhea.

PHYSICIANS interested in the treatment of venereal disease have been stimulated by the advent of the antibiotics to investigate the potentialities of these drugs in this field of endeavor. This discussion is concerned with the value of the commonly used antibiotics in the treatment of gonorrhea and its cutaneous manifestations, chancroid, lymphogranuloma venereum, and granuloma inguinale. More studies have been conducted to evaluate these drugs in the treatment of gonorrhea than in any other one of the venereal diseases, primarily because of the predominance of this infection. This report presents a review of the current literature as well as a summary of the work done in the department of dermatology and syphilology at the University of Maryland School of Medicine. GONORRHEA Penicillin.— There have been numerous reports attesting the value of penicillin in the treatment of gonorrhea. 1 It is an established fact that penicillin in doses sufficient to produce

Streptomycin therapy of erythema induratum.

Since streptomycin was first isolated from Streptomyces griseus, in September 1943, reports have appeared in the medical literature concerning its efficacy in treating various diseases of the skin. 1 Those conditions which have been reported as amenable to streptomycin therapy include lupus vulgaris, scrofuloderma, tuberculosis miliaris disseminata faciei, tuberculous ulcers of the tongue, tuberculosis verrucosa cutis, actinomycosis, tularemia, chancroid, granuloma inguinale and various dermatoses due to Pseudomonas aeruginosa (Bacillus pyocyaneus). 2 A careful search of the literature fails to reveal any reports on the treatment of erythema induratum with this antibiotic, and therefore two cases from the dermatology clinic at the Vanderbilt University Hospital are being recorded. REPORT OF CASES Case 1.— E. M., a 36 year old white housewife, was first seen in October 1945 at the Vanderbilt University clinic. The glands in her neck had begun enlarging eight months earlier, and a sudden acute swelling had appeared the preceding