Donovanosis natural history, complications and prognosis
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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
Natural History
- The incubation period of Klebsiella granulomatis is debated and ranges from 1 to 360 days with a median time of 50 days.[1]
- Donovanosis begins with a firm papule or subcutaneous nodule which eventually ulcerates.[2]
- The ulcer slowly progresses centrifugally, without pain, to form areas of granulomatous tissue.[3]
- Pseudoepitheliomatous hyperplasia of lesion borders, resembling squamous cell carcinoma, may occur.
- Ulcers may autoinoculate creating multiple lesions.
- "Pseudobuboes" may appear, which are nodular lesions that resemble lymphadenopathy.[4]
- Fibrosis may occur leading to elephantiasis-like swelling as a result of chronic ulcers.
- K. granulomatis may disseminate causing extragenital lesions in the following areas:[4]
- mouth
- cheek
- neck
- pharynx
- larynx
- nose
- thorax
- K. granulomatis may also disseminate to the abdomen, intestines, liver, lungs, uterus, and ovaries causing systemic infection.[3]
Complications
- Genital damage and scarring
- Elephantiasis-like swelling[4]
- Phimosis in men
- Strictures or fistulas of the urethra, vagina, or anus[3]
- Coinfection with other sexually transmitted infections including: syphillis, chancroid, and Human Immunodeficiency Virus (HIV)
- Carcinoma (in 0.25% of cases)[2]
Prognosis
- Treating this disease early decreases the chances of tissue damage or scarring. Untreated disease leads to damage of the genital tissue.
- Donovanosis may reoccur after 6 to 18 months.
References
- ↑ Greenblatt, R. B.; Dienst, R. B.; Pund, E. R.; Torpin, Richard (1939). "EXPERIMENTAL AND CLINICAL GRANULOMA INGUINALE". Journal of the American Medical Association. 113 (12): 1109. doi:10.1001/jama.1939.02800370025006. ISSN 0002-9955.
- ↑ 2.0 2.1 O'Farrell N (2002). "Donovanosis". Sex Transm Infect. 78 (6): 452–7. PMC 1758360. PMID 12473810.
- ↑ 3.0 3.1 3.2 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.
- ↑ 4.0 4.1 4.2 Richens J (1991). "The diagnosis and treatment of donovanosis (granuloma inguinale)". Genitourin Med. 67 (6): 441–52. PMC 1194766. PMID 1774048.