granuloma inguinale

関

donovanosis

WordNet

1. of or relating to or near the groin
2. a tumor composed of granulation tissue resulting from injury or inflammation or infection

PrepTutorEJDIC

1. 鼠蹊(そけい)部の(足のもものつけ根)

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2016/10/08 10:18:15」(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
Specialty	Infectious disease
ICD-10	A58
ICD-9-CM	099.2
DiseasesDB	3888
MedlinePlus	000636
eMedicine	derm/172
MeSH	D006100

Granuloma inguinale (also known as donovanosis) is a bacterial disease caused by Klebsiella granulomatis (formerly known as Calymmatobacterium 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, was 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 specific name granulomatis refers to the granulomatous lesions. The organism was recently reclassified under the genus Klebsiella, a drastic taxonomic change since it involved changing the organism's phylum. However, polymerase chain reaction 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 autoamputation 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 mild or absent. Tissue biopsy and Wright-Giemsa stain are 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

Recommended regimen is doxycycline 100 mg orally twice a day, alternatively with azithromycin 1 g orally once per week or ciprofloxacin 750 mg orally twice a day or erythromycin base 500 mg orally four times a day or trimethoprim-sulfamethoxazole one double-strength (160 mg/800 mg) tablet orally twice a day. All antibiotic regimens should last for at least 3 weeks and until all lesions have completely healed. Normally, the infection will begin to subside within a week of treatment, but the full treatment period must be followed to minimize the possibility of relapse.

Prevention

The disease is effectively treated with antibiotics, therefore, developed countries have a very low incidence of donovanosis; about 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 testing before beginning a sexual relationship, are effective preventative measures for donovanosis.

Gallery

• Donovanosis

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

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• 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. HIV感染患者における性器単純ヘルペスウイルスの疫学、臨床症状、および診断 epidemiology clinical manifestations and diagnosis of genital herpes simplex virus in hiv infected patients
• 5. 外陰部病変の鑑別診断 differential diagnosis of vulvar lesions

Japanese Journal

• Cutaneous Metastases of Rectal Mucinous Adenocarcinoma Mimicking Granuloma Inguinale

• Balta Ilknur,Vahaboglu Guler,Karabulut Ayse Anil,Yetisir Fahri,Astarci Muzeyyen,Gungor Emel,Eksioglu Meral
• Internal Medicine 51(17), 2479-2481, 2012
• … Therefore, the ulcerovegetative lesions of the patient were suspected to be granuloma inguinale (GI). …
• NAID 130002062351

• 細胞診による外陰の鼠径肉芽腫の診断

• 陳 欣栄,手島 英雄,日野 修一郎,松岡 良,森 宏之,藤原 作平
• 日本臨床細胞学会雑誌 26(3), 499-503, 1987-05-22
• NAID 110001221606

• Donovanosis (Granuloma Inguinale)

• 藤原 作平
• 西日本皮膚科 49(1), 3-4, 1987
• NAID 130004830657

Related Links

• Granuloma inguinale - Wikipedia, the free encyclopedia

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 ...

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★リンクテーブル★

リンク元	「鼠径部肉芽腫」「鼡径部肉芽腫」「鼠径肉芽腫」「鼡径肉芽腫」
拡張検索	「lymphogranuloma inguinale」
関連記事	「inguinal」

「鼠径部肉芽腫」

　　[★]

英

(n

• granuloma inguinale

関

鼠径リンパ肉芽腫症、鼠径肉芽腫、鼡径肉芽腫、鼡径部肉芽腫

「鼡径部肉芽腫」

　　[★]

ラ

granuloma inguinale

関

鼠径部肉芽腫、鼠径肉芽腫、鼡径肉芽腫

性感染症

「鼠径肉芽腫」

　　[★]

ラ

granuloma inguinale

関

鼠径部肉芽腫、鼡径肉芽腫、鼡径部肉芽腫

「鼡径肉芽腫」

　　[★]

ラ

granuloma inguinale

関

鼠径部肉芽腫、鼠径肉芽腫、鼡径部肉芽腫

「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

「inguinal」

　　[★]

• 鼠径部の、鼡径部の、鼠径の、鼡径の

関

groin、inguinal region、regio inguinalis