Donovanosis laboratory findings
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Kalsang Dolma, M.B.B.S.[2]; Nate Michalak, B.A.
Overview
Laboratory Findings
Microscopy
- Identification of Donovan bodies in tissue smears indicates donovanosis as a strong diagnosis. Donovan bodies are sufficiently unique from other etiologic agents that parasitize macrophages.[1]
- Slides can be created using two methods:[2]
- Tissue smear: after cleaning ulcer surface with saline, a cotton swab is rolled over the ulcer and then rolled over a slide.
- Tissue biopsy: tissue can be obtained from lesion with punch biopsy, forceps, or scalpel and then crushed between two slides. The lesion is often friable but local anesthetic may be necessary.
- Slides are then stained with Giemsa, Leishman's, or Wright's stain to reveal intracellular Donovan bodies within monocytes that may or may not be capsulated.[2]
- Haematoloxylin and eosin are poor stains.
- If swabs are taken for other diagnostic tests, the smear for Donovan bodies should be taken first to ensure there is adequate material to detect the Donovan bodies.
Culture
- K. granulomatis has been successfully cultured in human epithelial (HEp-2) cells with a technique adapted from Chlamydia culture.[3]
- Culturing K. granulomatis is difficult and not a practical means for diagnosis.
Polymerase Chain Reaction
- A PCR targeting the PhoE gene has been developed but is currently only available as a research tool.[2]
Serology
- An indirect immunofluorescence test has been developed but has a low sensitivity and is not practical for diagnosis.[2]
References
- ↑ Richens J (1991). "The diagnosis and treatment of donovanosis (granuloma inguinale)". Genitourin Med. 67 (6): 441–52. PMC 1194766. PMID 1774048.
- ↑ 2.0 2.1 2.2 2.3 O'Farrell N (2002). "Donovanosis". Sex Transm Infect. 78 (6): 452–7. PMC 1758360. PMID 12473810.
- ↑ Carter J, Hutton S, Sriprakash KS, Kemp DJ, Lum G, Savage J; et al. (1997). "Culture of the causative organism of donovanosis (Calymmatobacterium granulomatis) in HEp-2 cells". J Clin Microbiol. 35 (11): 2915–7. PMC 230086. PMID 9350758.