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
Donovanosis must be differentiated from other diseases that cause genital ulcers without lymphadenopathy including: primary or secondary syphilis, chancroid, herpes simplex, amoebiasis, and squamous cell carcinoma. Sexually transmitted diseases characterized as genital ulcer diseases may present with similar manifestations and lesion characteristics.
Differentiating Donovanosis from Other Diseases
Donovanosis must be differentiated from other diseases that cause genital ulcers without lymphadenopathy:[1]
- Primary or secondary syphilis
- Chancroid
- Herpes simplex
- Amoebiasis
- Squamous cell carcinoma
Other diseases that causes specifically granulomatous ulcers include:
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.[2]
| 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
- ↑ O'Farrell N (2002). "Donovanosis". Sex Transm Infect. 78 (6): 452–7. PMC 1758360. PMID 12473810.
- ↑ 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.