Donovanosis physical examination
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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]; 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
- Sulco coronal
- Balanopreputial region
- Anus
Common Locations in Females
- labia minora
- Vaginal furcula
- Cevix
- Fourchette
Extragenital Lesion Locations
Extragenital lesions occur in 6% of patients, typically in the following locations:[3]
Gallery
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Genital ulcer in a male patient with Donovanosis.Adapted from Dermatology Atlas.[4]
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Genital ulcer in a female patient with Donovanosis.Adapted from Dermatology Atlas.[4]
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Donovanosis. Adapted from Dermatology Atlas.[4]
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Granuloma inguinale, or Donovanosis, accompanied by perianal skin ulceration due to the bacterium, Klebsiella granulomatis. Adapted from Dermatology Atlas.[4]
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Donovanosis of penis. Adapted from Dermatology Atlas.[4]
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Donovanosis of penis. Adapted from Dermatology Atlas.[4]
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Preputial granulomatous lesion due to Donovanosis. Adapted from Dermatology Atlas.[4]
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Bilaterally infected inguinal lymph nodes due to a Calymmatobacterium granulomatis bacteria. Adapted from Dermatology Atlas.[4]
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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]
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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]
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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]
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This 19 year old woman presented with an perianal granuloma inguinale lesion of about 8 months duration. From Public Health Image Library (PHIL). [5]
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This patient presented with an ulcerated glans penis due to Donovanosis, or granuloma inguinale. From Public Health Image Library (PHIL). [5]
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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]
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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]
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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]
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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]
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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]
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)".