Donovanosis physical examination: Difference between revisions
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==Physical Examination== | ==Physical Examination== | ||
*In early stages donovanosis commonly presents as a nontender, progressive [[Ulcer|ulcerative]] lesions without regional [[lymphadenopathy]].<ref name=" O'Farrell" | *In early stages donovanosis commonly presents as a nontender, progressive [[Ulcer|ulcerative]] lesions without regional [[lymphadenopathy]].<ref name="O'Farrell" /> | ||
:*90% of cases involve [[genital]] region | :*90% of cases involve [[genital]] region | ||
:*10% of cases involve [[inguinal]] region | :*10% of cases involve [[inguinal]] region | ||
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*Serpiginous outline<ref name="Richens">{{cite journal| author=Richens J| title=The diagnosis and treatment of donovanosis (granuloma inguinale). | journal=Genitourin Med | year= 1991 | volume= 67 | issue= 6 | pages= 441-52 | pmid=1774048 | doi= | pmc=PMC1194766 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1774048 }} </ref> | *Serpiginous outline<ref name="Richens">{{cite journal| author=Richens J| title=The diagnosis and treatment of donovanosis (granuloma inguinale). | journal=Genitourin Med | year= 1991 | volume= 67 | issue= 6 | pages= 441-52 | pmid=1774048 | doi= | pmc=PMC1194766 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1774048 }} </ref> | ||
Four variants can be further classified according to their clinical presentation:<ref name=" O'Farrell">{{cite journal| author=O'Farrell N| title=Donovanosis. | journal=Sex Transm Infect | year= 2002 | volume= 78 | issue= 6 | pages= 452-7 | pmid=12473810 | doi= | pmc=PMC1758360 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12473810 }} </ref> | Four variants can be further classified according to their clinical presentation:<ref name="O'Farrell">{{cite journal| author=O'Farrell N| title=Donovanosis. | journal=Sex Transm Infect | year= 2002 | volume= 78 | issue= 6 | pages= 452-7 | pmid=12473810 | doi= | pmc=PMC1758360 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12473810 }} </ref> | ||
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===Common Locations in Males=== | ===Common Locations in Males=== | ||
*[[ | *[[Coronal sulcus]] | ||
*[[ | *[[Prepuce|Subpreputial]] region | ||
*[[Anus]] | *[[Anus]] | ||
===Common Locations in Females=== | ===Common Locations in Females=== | ||
*[[labia minora]] | *[[labia minora]] | ||
*[[Cervix]] | |||
*[[ | |||
*[[Fourchette]] | *[[Fourchette]] | ||
===Extragenital Lesion Locations=== | ===Extragenital Lesion Locations=== | ||
Extragenital lesions occur in 6% of patients, typically in the following locations:<ref name="Richens" | Extragenital lesions occur in 6% of patients, typically in the following locations:<ref name="Richens" /> | ||
:*[[Mouth (human)|mouth]] | :*[[Mouth (human)|mouth]] | ||
:*[[cheek]] | :*[[cheek]] | ||
Revision as of 20:41, 2 March 2016
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Donovanosis Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Donovanosis physical examination On the Web |
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American Roentgen Ray Society Images of Donovanosis physical examination |
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Risk calculators and risk factors for Donovanosis physical examination |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Kalsang Dolma, M.B.B.S.[2]; Kiran Singh, M.D. [3]; Nate Michalak, B.A.
Overview
Clinically, the disease is commonly characterized as painless, progressive ulcerative lesions without regional lymphadenopathy.
Physical Examination
- In early stages donovanosis commonly presents as a nontender, progressive ulcerative lesions without regional lymphadenopathy.[1]
- Patients in late stages present with the following signs:[2]
- Scarring
- Elephantiasis-like swelling
- Stenosis of the urethra, vagina, or anus
Typical Lesion Characteristics
- Beefy red color
- Nontender
- Emit rank odor
- Elevated above skin
- Smooth, rolled edge
- Serpiginous outline[3]
Four variants can be further classified according to their clinical presentation:[1]
| Type | Clinical Appearance |
|---|---|
| Ulcerogrnulomatous | beefy red, non-tender, bleeds easily |
| Hypertrophic or Verrucous | irregular edge, dry |
| Necrotic | foul smelling, deep, tissue destruction |
| Sclerotic | dry, cicatricial, fibrous scar tissue |
Common Locations in Males
- Coronal sulcus
- Subpreputial region
- Anus
Common Locations in Females
Extragenital Lesion Locations
Extragenital lesions occur in 6% of patients, typically in the following locations:[3]
Gallery
-
![Genital ulcer in a male patient with Donovanosis.Adapted from Dermatology Atlas.[4]](/images/5/5d/SOA-Donovanosis-male.jpg)
Genital ulcer in a male patient with Donovanosis.Adapted from Dermatology Atlas.[4]
-
![Genital ulcer in a female patient with Donovanosis.Adapted from Dermatology Atlas.[4]](/images/e/e7/SOA-Donovanosis-female.jpg)
Genital ulcer in a female patient with Donovanosis.Adapted from Dermatology Atlas.[4]
-
![Donovanosis. Adapted from Dermatology Atlas.[4]](/images/3/38/Donovanosis01.jpg)
Donovanosis. Adapted from Dermatology Atlas.[4]
-
![Granuloma inguinale, or Donovanosis, accompanied by perianal skin ulceration due to the bacterium, Klebsiella granulomatis. Adapted from Dermatology Atlas.[4]](/images/0/0b/Enterobacteria62.jpeg)
Granuloma inguinale, or Donovanosis, accompanied by perianal skin ulceration due to the bacterium, Klebsiella granulomatis. Adapted from Dermatology Atlas.[4]
-
![Donovanosis of penis. Adapted from Dermatology Atlas.[4]](/images/1/17/Enterobacteria54.jpeg)
Donovanosis of penis. Adapted from Dermatology Atlas.[4]
-
![Donovanosis of penis. Adapted from Dermatology Atlas.[4]](/images/a/a6/Enterobacteria53.jpeg)
Donovanosis of penis. Adapted from Dermatology Atlas.[4]
-
![Preputial granulomatous lesion due to Donovanosis. Adapted from Dermatology Atlas.[4]](/images/7/7f/Enterobacteria51.jpeg)
Preputial granulomatous lesion due to Donovanosis. Adapted from Dermatology Atlas.[4]
-
![Bilaterally infected inguinal lymph nodes due to a Calymmatobacterium granulomatis bacteria. Adapted from Dermatology Atlas.[4]](/images/a/a2/Enterobacteria49.jpeg)
Bilaterally infected inguinal lymph nodes due to a Calymmatobacterium granulomatis bacteria. Adapted from Dermatology Atlas.[4]
-
![This patient presented with a case of systemically disseminated Donovanosis of the ankle due to C. granulomatis bacteria. From Public Health Image Library (PHIL). [5]](/images/4/4a/Granuloma_inguinale11.jpeg)
This patient presented with a case of systemically disseminated Donovanosis of the ankle due to C. granulomatis bacteria. From Public Health Image Library (PHIL). [5]
-
![This male presented with a penile lesion that was found to be granuloma inguinale, also called “genital ulcerative disease”. From Public Health Image Library (PHIL). [5]](/images/3/3c/Granuloma_inguinale10.jpeg)
This male presented with a penile lesion that was found to be granuloma inguinale, also called “genital ulcerative disease”. From Public Health Image Library (PHIL). [5]
-
![This male presented with a penile lesion of roughly 40 days duration that was determined to be granuloma inguinale. From Public Health Image Library (PHIL). [5]](/images/f/f8/Granuloma_inguinale09.jpeg)
This male presented with a penile lesion of roughly 40 days duration that was determined to be granuloma inguinale. From Public Health Image Library (PHIL). [5]
-
![This 19 year old woman presented with an perianal granuloma inguinale lesion of about 8 months duration. From Public Health Image Library (PHIL). [5]](/images/5/50/Granuloma_inguinale08.jpeg)
This 19 year old woman presented with an perianal granuloma inguinale lesion of about 8 months duration. From Public Health Image Library (PHIL). [5]
-
![This patient presented with an ulcerated glans penis due to Donovanosis, or granuloma inguinale. From Public Health Image Library (PHIL). [5]](/images/a/a4/Granuloma_inguinale07.jpeg)
This patient presented with an ulcerated glans penis due to Donovanosis, or granuloma inguinale. From Public Health Image Library (PHIL). [5]
-
![This image depicts an intravaginal view revealing a cervical lesion, which had been diagnosed as a case of Donovanosis, also known as granuloma inguinale. From Public Health Image Library (PHIL). [5]](/images/2/2e/Granuloma_inguinale06.jpeg)
This image depicts an intravaginal view revealing a cervical lesion, which had been diagnosed as a case of Donovanosis, also known as granuloma inguinale. From Public Health Image Library (PHIL). [5]
-
![This image depicts the penis of a male with its foreskin retracted, revealing a suppurative lesion involving the glans and prepuce. From Public Health Image Library (PHIL). [5]](/images/1/10/Granuloma_inguinale05.jpeg)
This image depicts the penis of a male with its foreskin retracted, revealing a suppurative lesion involving the glans and prepuce. From Public Health Image Library (PHIL). [5]
-
![This image depicts the penis of a male patient who had presented with a lesion located on the lateral preputial skin just proximal to the corona of the glans. The lesion was characterized as a penile granulomata, due to a case of Donovanosis, or granuloma inguinale. From Public Health Image Library (PHIL). [5]](/images/2/2a/Granuloma_inguinale03.jpeg)
This image depicts the penis of a male patient who had presented with a lesion located on the lateral preputial skin just proximal to the corona of the glans. The lesion was characterized as a penile granulomata, due to a case of Donovanosis, or granuloma inguinale. From Public Health Image Library (PHIL). [5]
-
![This patient showed manifestations of granuloma inguinale, also known as Donovanosis, involving swelling and subcutaneous granulomas of the inguinal lymph nodes, bilaterally. From Public Health Image Library (PHIL). [5]](/images/8/82/Granuloma_inguinale02.jpeg)
This patient showed manifestations of granuloma inguinale, also known as Donovanosis, involving swelling and subcutaneous granulomas of the inguinal lymph nodes, bilaterally. From Public Health Image Library (PHIL). [5]
-
![This was a very large erosive cutaneous lesion in the perineal region of this patient, which had been diagnosed as Donovanosis, otherwise known as granuloma inguinale. From Public Health Image Library (PHIL). [5]](/images/6/6d/Granuloma_inguinale01.jpeg)
This was a very large erosive cutaneous lesion in the perineal region of this patient, which had been diagnosed as Donovanosis, otherwise known as granuloma inguinale. From Public Health Image Library (PHIL). [5]
![Genital ulcer in a male patient with Donovanosis.Adapted from Dermatology Atlas.[4]](/index.php/File:SOA-Donovanosis-male.jpg)
![Genital ulcer in a female patient with Donovanosis.Adapted from Dermatology Atlas.[4]](/index.php/File:SOA-Donovanosis-female.jpg)
![Donovanosis. Adapted from Dermatology Atlas.[4]](/index.php/File:Donovanosis01.jpg)
![Granuloma inguinale, or Donovanosis, accompanied by perianal skin ulceration due to the bacterium, Klebsiella granulomatis. Adapted from Dermatology Atlas.[4]](/index.php/File:Enterobacteria62.jpeg)
![Donovanosis of penis. Adapted from Dermatology Atlas.[4]](/index.php/File:Enterobacteria54.jpeg)
![Donovanosis of penis. Adapted from Dermatology Atlas.[4]](/index.php/File:Enterobacteria53.jpeg)
![Preputial granulomatous lesion due to Donovanosis. Adapted from Dermatology Atlas.[4]](/index.php/File:Enterobacteria51.jpeg)
![Bilaterally infected inguinal lymph nodes due to a Calymmatobacterium granulomatis bacteria. Adapted from Dermatology Atlas.[4]](/index.php/File:Enterobacteria49.jpeg)
![This patient presented with a case of systemically disseminated Donovanosis of the ankle due to C. granulomatis bacteria. From Public Health Image Library (PHIL). [5]](/index.php/File:Granuloma_inguinale11.jpeg)
![This male presented with a penile lesion that was found to be granuloma inguinale, also called “genital ulcerative disease”. From Public Health Image Library (PHIL). [5]](/index.php/File:Granuloma_inguinale10.jpeg)
![This male presented with a penile lesion of roughly 40 days duration that was determined to be granuloma inguinale. From Public Health Image Library (PHIL). [5]](/index.php/File:Granuloma_inguinale09.jpeg)
![This 19 year old woman presented with an perianal granuloma inguinale lesion of about 8 months duration. From Public Health Image Library (PHIL). [5]](/index.php/File:Granuloma_inguinale08.jpeg)
![This patient presented with an ulcerated glans penis due to Donovanosis, or granuloma inguinale. From Public Health Image Library (PHIL). [5]](/index.php/File:Granuloma_inguinale07.jpeg)
![This image depicts an intravaginal view revealing a cervical lesion, which had been diagnosed as a case of Donovanosis, also known as granuloma inguinale. From Public Health Image Library (PHIL). [5]](/index.php/File:Granuloma_inguinale06.jpeg)
![This image depicts the penis of a male with its foreskin retracted, revealing a suppurative lesion involving the glans and prepuce. From Public Health Image Library (PHIL). [5]](/index.php/File:Granuloma_inguinale05.jpeg)
![This image depicts the penis of a male patient who had presented with a lesion located on the lateral preputial skin just proximal to the corona of the glans. The lesion was characterized as a penile granulomata, due to a case of Donovanosis, or granuloma inguinale. From Public Health Image Library (PHIL). [5]](/index.php/File:Granuloma_inguinale03.jpeg)
![This patient showed manifestations of granuloma inguinale, also known as Donovanosis, involving swelling and subcutaneous granulomas of the inguinal lymph nodes, bilaterally. From Public Health Image Library (PHIL). [5]](/index.php/File:Granuloma_inguinale02.jpeg)
![This was a very large erosive cutaneous lesion in the perineal region of this patient, which had been diagnosed as Donovanosis, otherwise known as granuloma inguinale. From Public Health Image Library (PHIL). [5]](/index.php/File:Granuloma_inguinale01.jpeg)
References
- ↑ 1.0 1.1 O'Farrell N (2002). "Donovanosis". Sex Transm Infect. 78 (6): 452–7. PMC 1758360. PMID 12473810.
- ↑ Velho, Paulo Eduardo Neves Ferreira; Souza, Elemir Macedo de; Belda Junior, Walter (2008). "Donovanosis". Brazilian Journal of Infectious Diseases. 12 (6). doi:10.1590/S1413-86702008000600015. ISSN 1413-8670.
- ↑ 3.0 3.1 Richens J (1991). "The diagnosis and treatment of donovanosis (granuloma inguinale)". Genitourin Med. 67 (6): 441–52. PMC 1194766. PMID 1774048.
- ↑ 4.0 4.1 4.2 4.3 4.4 4.5 4.6 4.7 "Dermatology Atlas".
- ↑ 5.0 5.1 5.2 5.3 5.4 5.5 5.6 5.7 5.8 5.9 "Public Health Image Library (PHIL)".