Donovanosis differential diagnosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Nate Michalak, B.A.
Overview
Differentiating Donovanosis from Other Diseases
Donovanosis must be differentiated from other diseases that cause genital ulcers without lymphadenopathy:
- Primary or secondary syphilis
- Chancroid
- Herpes simplex
- Amoebiasis
- Squamous cell carcinoma
Sexually transmitted diseases characterized as genital ulcer diseases may present with similar manifestations and lesion characteristics. A diagnosis based only on the patient’s medical history and physical examination frequently is inaccurate. Patients who have genital, anal, or perianal ulcers should be evaluated with laboratory tests to make a definitive diagnosis.[1]
| Clinical Characteristic | Sexually Transmitted Disease | ||||
|---|---|---|---|---|---|
| Chancroid | Genital Herpes | Donovanosis | LGV | Syphilis | |
| Cause | Haemophilus ducreyi | Herpes Simplex Virus (HSV-1 & HSV-2) | Klebsiella granulomatis | Chlamydia trachomatis serovars L1, L2, or L3 | Treponema pallidum |
| Lesion Type | Papule evolving to ulcer | Vesicle evolving to ulcer | Ulcer progressing to granuloma | Self-limited papule or ulcer | Papule evolving to ulcer |
| Lesion Border | Crater with irregular, sharp margins | Circular, sharp margins on erythematous base | Friable base with sharp, raised, rolled margin | Shallow, smooth border | Crater with raised edges, smooth margins |
| Lesion Distribution | Single or multiple | Multiple, in group/crop | Single or multiple | Single or herpetiform | Multiple |
| Lesion Texture | Soft | Umbilicated | Granulomatous | Firm bump | Indurated |
| Lesion Tenderness | Present | Present | Absent | Absent | Absent |
| Lesion Exudate | Grey/yellow purulent exudate | Non-exudative | Non-exudative but bleeds easily | Non-exudative | Non-exudative; non-fluctuant |
| Lymphadenopathy | Present and tender in approx. half of patients (typically unilateral) | Present and tender | Absent from primary infection; pseudobuboes may occur | Present and tender | Present and non-tender (uni- or bilateral) |
References
- ↑ 2015 Sexually Transmitted Diseases Treatment Guidelines. Centers for Disease Control and Prevention (June 4, 2015). http://www.cdc.gov/std/tg2015/genital-ulcers.htm Accessed February 18, 2016.