Donovanosis natural history, complications and prognosis: Difference between revisions

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*Donovanosis begins with a firm [[papule]] or [[subcutaneous]] [[nodule]] which eventually ulcerates.<ref name=" O'Farrell">{{cite journal| author=O'Farrell N| title=Donovanosis. | journal=Sex Transm Infect | year= 2002 | volume= 78 | issue= 6 | pages= 452-7 | pmid=12473810 | doi= | pmc=PMC1758360 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12473810  }} </ref>
*Donovanosis begins with a firm [[papule]] or [[subcutaneous]] [[nodule]] which eventually ulcerates.<ref name=" O'Farrell">{{cite journal| author=O'Farrell N| title=Donovanosis. | journal=Sex Transm Infect | year= 2002 | volume= 78 | issue= 6 | pages= 452-7 | pmid=12473810 | doi= | pmc=PMC1758360 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12473810  }} </ref>
*The [[ulcer]] slowly progresses centrifugally, without pain, to form areas of granulomatous tissue.<ref name="VelhoSouza2008">{{cite journal|last1=Velho|first1=Paulo Eduardo Neves Ferreira|last2=Souza|first2=Elemir Macedo de|last3=Belda Junior|first3=Walter|title=Donovanosis|journal=Brazilian Journal of Infectious Diseases|volume=12|issue=6|year=2008|issn=1413-8670|doi=10.1590/S1413-86702008000600015}}</ref>
*The [[ulcer]] slowly progresses centrifugally, without pain, to form areas of granulomatous tissue.<ref name="VelhoSouza2008">{{cite journal|last1=Velho|first1=Paulo Eduardo Neves Ferreira|last2=Souza|first2=Elemir Macedo de|last3=Belda Junior|first3=Walter|title=Donovanosis|journal=Brazilian Journal of Infectious Diseases|volume=12|issue=6|year=2008|issn=1413-8670|doi=10.1590/S1413-86702008000600015}}</ref>
*Pseudoepitheliomatous [[hyperplasia]] of lesion borders, resembling [[squamous cell carcinoma]] may occur.
*Pseudoepitheliomatous [[hyperplasia]] of lesion borders, resembling [[squamous cell carcinoma]], may occur.
*Ulcers may autoinoculate creating multiple lesions.
*Ulcers may autoinoculate creating multiple lesions.
*"Pseudobuboes" may appear, which are nodular lesions that resemble [[lymphadenopathy]].<ref name="Richens">{{cite journal| author=Richens J| title=The diagnosis and treatment of donovanosis (granuloma inguinale). | journal=Genitourin Med | year= 1991 | volume= 67 | issue= 6 | pages= 441-52 | pmid=1774048 | doi= | pmc=PMC1194766 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1774048  }} </ref>
*"Pseudobuboes" may appear, which are nodular lesions that resemble [[lymphadenopathy]].<ref name="Richens">{{cite journal| author=Richens J| title=The diagnosis and treatment of donovanosis (granuloma inguinale). | journal=Genitourin Med | year= 1991 | volume= 67 | issue= 6 | pages= 441-52 | pmid=1774048 | doi= | pmc=PMC1194766 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1774048  }} </ref>

Revision as of 15:02, 2 March 2016

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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

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

  1. 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. 2.0 2.1 O'Farrell N (2002). "Donovanosis". Sex Transm Infect. 78 (6): 452–7. PMC 1758360. PMID 12473810.
  3. 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. 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.

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