Donovanosis Flashcards
What bacteria causes donovanosis?
Calymmatobacterium granulomatis (however classification is debated)
What other species class does the organism that causes donovanosis have similarity with?
Klebsiella (therefore could be re classified as Klebsiella granulomatis comb nov.)
Through which route does transmission of donovanosis occur?
Sexually transmitted (however debated)
What age range of people are most likely to have donovanosis?
20-40 yr old
Where in the World is donovanosis most likely to appear?
RARE Papua New Guinea southern Africa parts of India Brazil
What is the typical presentation of donovanosis?
firm papule or subcutaneous nodule that later ulcerates
Four types of donovanosis are described classically, what are they?
Ulcerogranulomatous
Hypertrophic or verrucous type
Necrotic
Sclerotic
Describe the appearance of Ulcerogranulomatous donovanosis.
non-tender fleshy exuberant single or multiple beefy red ulcers bleed readily when touched
Describe the appearance of Hypertrophic or verrucous type donovanosis.
ulcer or growth
raised irregular edge
walnut appearance
Describe the appearance of Necrotic donovanosis.
deep foul-smelling ulcer
tissue destruction
Describe the appearance of Sclerotic donovanosis.
extensive fibrous and scar tissue
Which presentation of donovanosis is most common?
ulcerogranulomatous
Which sites of the body can be affected by donovanosis?
Genitals Inguinal area Extra genital - lip - gum - cheek - palate - pharynx
If secondary spread of donovanosis occurs where does it go?
liver
bone
If secondary spread of donovanosis occurs what is it typically associated with?
Pregnancy
Cervical lesions
Where on the male genitals does donovanosis occur?
the prepuce
coronal sulcus
frenum
glans penis
Where on the female genitals does donovanosis occur?
labia minora
fourchette
What other condition/pathology may mimic or complicate donovanosis?
squamous cell carcinoma
How should a sample of an ulcer looking for donovanosis be taken/prepared for microscopy?
roll a swab firmly across the ulcer
roll this swab evenly across a glass slide
rapid Giemsa stain
Microscopy - charateristic findings - donovanosis
large mononuclear cells with intracytoplasmic cysts filled with deeply-stained Gram-negative pleomorphic Donovan bodies
What are Donovan bodies?
Rod-shaped, oval organisms
What is the recommended regimen for treatment of donovanosis?
3 WEEKS and until lesions completely healed
Azithromycin 1gram WEEKLY
Azithromycin 500mg DAILY
What ALTERNATIVE regimens may be used for treatment of donovanosis?
Co-trimoxazole 160/800 mg bd orally
Doxycycline 100 mg bd orally
Erythromycin 500 mg four times daily orally.
Gentamicin 1 mg/kg every 8 h parenterally
For PREGNANT women, what is the recommended regimen for treatment of donovanosis?
Erythromycin 500mg 4 times daily
