donovanosis

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2013/09/16 18:05:44」(JST)

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This article is about the ulcerative disease caused by Klebsiella granulomatis. For sexually transmitted disease caused by certain types of chlamydia, see Lymphogranuloma venereum.

Granuloma inguinale
Classification and external resources
Donovanosis of the penis.
ICD-10	A58
ICD-9	099.2
DiseasesDB	3888
MedlinePlus	000636
eMedicine	derm/172
MeSH	D006100

Granuloma inguinale is a bacterial disease caused by Klebsiella granulomatis characterized by ulcerative genital lesions. It is endemic in many less developed regions. It is also known as donovanosis, granuloma genitoinguinale, granuloma inguinale tropicum, granuloma venereum, granuloma venereum genitoinguinale, lupoid form of groin ulceration, serpiginous ulceration of the groin, ulcerating granuloma of the pudendum and ulcerating sclerosing granuloma.

The disease often goes untreated because of the scarcity of medical treatment in the countries in which it is found. In addition, the painless genital ulcers can be mistaken for syphilis. The ulcers ultimately progress to destruction of internal and external tissue, with extensive leakage of mucus and blood from the highly vascular lesions. The destructive nature of donovanosis also increases the risk of superinfection by other pathogenic microbes.

Classification and terminology

The first known name for this condition was "serpiginous ulcer", which dates to 1882. The proper clinical designation for donovanosis is now "granuloma inguinale". A granuloma is a nodular type of inflammatory reaction, and inguinale refers to the inguinal region, which is commonly involved in this infection. The disease is commonly known as donovanosis, after the Donovan bodies which are a diagnostic sign.

The causative organism, Klebsiella granulomatis, used to be called Calymmatobacterium granulomatis, and some sources still use this classification, from the Greek kalymma (a hood or veil), referring to the lesions that contain the bacteria. Prior to this it was called Donovania granulomatis, named after the Donovan bodies.

The species name granulomatis refers to the granulomatous lesions. The organism was recently reclassified under the genus Klebsiella, drastic taxonomic change, since it involved changing the organism's phylum. However, polymerase chain reaction (PCR) techniques using a colorimetric detection system showed a 99% similarity with other species in the Klebsiella genus.

Symptoms

Small, painless nodules appear after about 10–40 days of the contact with the bacteria. Later the nodules burst, creating open, fleshy, oozing lesions. The infection spreads, mutilating the infected tissue. The infection will continue to destroy the tissue until treated. The lesions occur at the region of contact typically found on the shaft of the penis, the labia, or the perineum. Rarely, the vaginal wall or cervix is the site of the lesion. At least one case in India led to partial auto-amputation of the penis. The patient tested positive for HIV-2 and had been infected for six years.

Transmission

The microorganism spreads from one host to another through contact with the open sores.

Diagnosis

The diagnosis is based on the patient's sexual history and on physical examination revealing a painless, "beefy-red ulcer" with a characteristic rolled edge of granulation tissue. In contrast to syphilitic ulcers, inguinal lymphadenopathy is generally absent. Tissue biopsy and Wright-Giemsa stain is used to aid in the diagnosis. The presence of Donovan bodies in the tissue sample confirms donovanosis. Donovan bodies are rod-shaped, oval organisms that can be seen in the cytoplasm of mononuclear phagocytes or histiocytes in tissue samples from patients with granuloma inguinale.

They appear deep purple when stained with Wright's stain. These intracellular inclusions are the encapsulated gram-negative rods of the causative organisms. They were discovered by Charles Donovan.

Treatment

Three weeks of treatment with erythromycin, streptomycin, or tetracycline, or 12 weeks of treatment with ampicillin are standard forms of therapy. Normally, the infection will begin to subside within a week of treatment, but the full treatment period must be followed in order to minimize the possibility of relapse.

Prevention

The disease is effectively treated with antibiotics, therefore, developed countries, like the United States, have a very low incidence of donovanosis, approximately 100 cases reported each year in the United States. However, sexual contacts with individuals in endemic regions dramatically increases the risk of contracting the disease. Avoidance of these sexual contacts, and sexually transmitted disease (STD) testing before beginning a sexual relationship, are effective preventative measures for donovanosis.

Additional images

• Donovanosis

• Donovanosis-male

• Donovanosis-female

See also

• Chancroid
• List of cutaneous conditions

References

External links

• Gavin Hart MD, MPH Transcript of the lecture given at the Australian Society for Infectious Diseases/Australasian College of Tropical Medicine Conference at Palm Cove (Cairns), Queensland on 19 April 1999.
• Research supporting Klebsiella Genus classification
• http://www.epigee.org/health/granu_ingui.html
• http://www.healthatoz.com/healthatoz/Atoz/ency/granuloma_inguinale.jsp
• http://www.indepthlearning.org/std/STDnew.php/76C.html
• http://www.stdservices.on.net/publications/pdf/donovanosis.pdf
• http://www.fasthealth.com/dictionary/c/Calymmatobacterium.php
• Resource Library:Granuloma inguinale
• http://www.bacterio.cict.fr/e/enterobacteriaceae.html
• http://www.mansfield.ohio-state.edu/~sabedon/biol3018.htm
• http://www.dscc.edu/bwilliams/Biology/Monera.htm

UpToDate Contents

全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.

• 1. 性器潰瘍患者へのアプローチ approach to the patient with genital ulcers
• 2. 軟性下疳 chancroid
• 3. 小児における鼠径部腫脹の評価 evaluation of inguinal swelling in children
• 4. 汗腺膿瘍の病因、臨床的特徴、および診断 pathogenesis clinical features and diagnosis of hidradenitis suppurativa
• 5. 外陰部病変の鑑別診断 differential diagnosis of vulvar lesions

English Journal

• On the evolution of the sexually transmitted bacteria Haemophilus ducreyi and Klebsiella granulomatis.

• Lagergård T, Bölin I, Lindholm L.SourceDepartment of Microbiology and Immunology, Institute of Biomedicine, University of Gothenburg, Gothenburg, Sweden.
• Annals of the New York Academy of Sciences.Ann N Y Acad Sci.2011 Aug;1230(1):E1-E10. doi: 10.1111/j.1749-6632.2011.06193.x.
• Haemophilus ducreyi and Klebsiella (Calymmatobacterium) granulomatis are sexually transmitted bacteria that cause characteristic, persisting ulceration on external genitals called chancroid and granuloma inguinale, respectively. Those ulcers are endemic in developing countries or exist, as does gran
• PMID 22239475

Related Links

• Donovanosis (granuloma inguinale): MedlinePlus Medical ...

Avoiding all sexual activity is the only absolute way to prevent a sexually transmitted disease such as donovanosis. However, safer sex behaviors may reduce your risk. The proper use of condoms, either the male or ...

• Donovanosis | Define Donovanosis at Dictionary.com

donovanosis don·o·va·no·sis (dŏn'ə-və-nō'sĭs) n. A chronic destructive ulceration of the inguinal region and the external genitalia caused by Calymmatobacterium granulomatis, which is observed intracellularly as Leishman-Donovan ...

Related Pictures

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★リンクテーブル★

リンク元	「鼠径リンパ肉芽腫症」「lymphogranuloma inguinale」

「鼠径リンパ肉芽腫症」

　　[★]

ラ

lymphogranulomatosis inguinale

同

第四性病 fourth venereal disease、性病性リンパ肉芽腫 lymphogranuloma venereum LGV、ニコラ・ファーヴル病 Nicolas-Favre disease、フライ病 Frei disease、donovanosis

鼠径リンパ肉芽腫、性病性リンパ肉芽腫症、鼡径リンパ肉芽腫、鼡径リンパ肉芽腫症

関

クラミジア、性感染症、

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鼡径リンパ肉芽腫症 : 35 件
鼠径リンパ肉芽腫症 : 約 88,200 件

「lymphogranuloma inguinale」

　　[★]

鼠径リンパ肉芽腫症、鼡径リンパ肉芽腫症

関

donovanosis、LGV、lymphogranuloma venereum