Donovanosis

Question 1

What bacteria causes donovanosis?

Answer 1

Calymmatobacterium granulomatis (however classification is debated)

Question 2

What other species class does the organism that causes donovanosis have similarity with?

Answer 2

Klebsiella (therefore could be re classified as Klebsiella granulomatis comb nov.)

Question 3

Through which route does transmission of donovanosis occur?

Answer 3

Sexually transmitted (however debated)

Question 4

What age range of people are most likely to have donovanosis?

Answer 4

20-40 yr old

Question 5

Where in the World is donovanosis most likely to appear?

Answer 5

RARE
Papua New Guinea
southern Africa
parts of India
Brazil

Question 6

What is the typical presentation of donovanosis?

Answer 6

firm papule or subcutaneous nodule that later ulcerates

Question 7

Four types of donovanosis are described classically, what are they?

Answer 7

Ulcerogranulomatous
Hypertrophic or verrucous type
Necrotic
Sclerotic

Question 8

Describe the appearance of Ulcerogranulomatous donovanosis.

Answer 8

non-tender
fleshy
exuberant
single or multiple
beefy red ulcers
bleed readily when touched

Question 9

Describe the appearance of Hypertrophic or verrucous type donovanosis.

Answer 9

ulcer or growth
raised irregular edge
walnut appearance

Question 10

Describe the appearance of Necrotic donovanosis.

Answer 10

deep foul-smelling ulcer

tissue destruction

Question 11

Describe the appearance of Sclerotic donovanosis.

Answer 11

extensive fibrous and scar tissue

Question 12

Which presentation of donovanosis is most common?

Answer 12

ulcerogranulomatous

Question 13

Which sites of the body can be affected by donovanosis?

Answer 13

Genitals
Inguinal area
Extra genital
- lip
- gum
- cheek
- palate
- pharynx

Question 14

If secondary spread of donovanosis occurs where does it go?

Answer 14

liver

bone

Question 15

If secondary spread of donovanosis occurs what is it typically associated with?

Answer 15

Pregnancy

Cervical lesions

Question 16

Where on the male genitals does donovanosis occur?

Answer 16

the prepuce
coronal sulcus
frenum
glans penis

Question 17

Where on the female genitals does donovanosis occur?

Answer 17

labia minora

fourchette

Question 18

What other condition/pathology may mimic or complicate donovanosis?

Answer 18

squamous cell carcinoma

Question 19

How should a sample of an ulcer looking for donovanosis be taken/prepared for microscopy?

Answer 19

roll a swab firmly across the ulcer
roll this swab evenly across a glass slide
rapid Giemsa stain

Question 20

Microscopy - charateristic findings - donovanosis

Answer 20

large mononuclear cells
with intracytoplasmic cysts
filled with deeply-stained Gram-negative 
pleomorphic
Donovan bodies

Question 21

What are Donovan bodies?

Answer 21

Rod-shaped, oval organisms

Question 22

What is the recommended regimen for treatment of donovanosis?

Answer 22

3 WEEKS and until lesions completely healed
Azithromycin 1gram WEEKLY
Azithromycin 500mg DAILY

Question 23

What ALTERNATIVE regimens may be used for treatment of donovanosis?

Answer 23

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

Question 24

For PREGNANT women, what is the recommended regimen for treatment of donovanosis?

Answer 24

Erythromycin 500mg 4 times daily