Donovanosis natural history, complications and prognosis: Difference between revisions
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==Overview== | ==Overview== | ||
The incubation period of ''Klebsiella granulomatis'' is debated and ranges from 1 to 360 days with a median time of 50 days. Donovanosis starts as a [[papule]] or [[subcutaneous]] [[nodule]] which eventually ulcerates. The [[ulcer]] progresses to create areas of [[granulomatous]] tissue. Pseudoepitheliomatous [[hyperplasia]] of lesion borders often occurs. Ulcers autoinoculate creating multiple lesions. "Pseudobuboes" may also develop. Chronic ulcers leads to [[fibrosis]] and eventually [[Elephantiasis]]-like swelling. ''K. granulomatis'' may disseminate causing extragenital lesions and systemic infection. Complications include: genital damage and scarring, [[elephantiasis]], [[phimosis]] in men, [strictures]] or [[fistulas]] of the [[urethra]], [[vagina]], or [[anus]], [[foinfection]] with other [[sexually transmitted infections]] and [[carcinoma]] (in 0.25% of cases). Prognosis is poor without treatment because the disease has a high [[morbidity]]; untreated disease leads to damage of the genital tissue, scarring, and [[elephantiasis]]. Donovanosis may reoccur after 6 to 18 months after treatment. | |||
==Natural History== | ==Natural History== | ||
*The incubation period of ''Klebsiella granulomatis'' is debated and ranges from 1 to 360 days with a median time of 50 days.<ref name="GreenblattDienst1939">{{cite journal|last1=Greenblatt|first1=R. B.|last2=Dienst|first2=R. B.|last3=Pund|first3=E. R.|last4=Torpin|first4=Richard|title=EXPERIMENTAL AND CLINICAL GRANULOMA INGUINALE|journal=Journal of the American Medical Association|volume=113|issue=12|year=1939|pages=1109|issn=0002-9955|doi=10.1001/jama.1939.02800370025006}}</ref> | *The incubation period of ''Klebsiella granulomatis'' is debated and ranges from 1 to 360 days with a median time of 50 days.<ref name="GreenblattDienst1939">{{cite journal|last1=Greenblatt|first1=R. B.|last2=Dienst|first2=R. B.|last3=Pund|first3=E. R.|last4=Torpin|first4=Richard|title=EXPERIMENTAL AND CLINICAL GRANULOMA INGUINALE|journal=Journal of the American Medical Association|volume=113|issue=12|year=1939|pages=1109|issn=0002-9955|doi=10.1001/jama.1939.02800370025006}}</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> | *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]], often occurs. | |||
*Ulcers may autoinoculate creating multiple lesions. | *Ulcers may autoinoculate creating multiple lesions. | ||
*"Pseudobuboes" may | *"Pseudobuboes" may develop, which are nodular lesions that resemble [[lymphadenitis]].<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> | ||
*[[Fibrosis]] may occur leading to [[elephantiasis]]-like swelling as a result of chronic ulcers. | *[[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:<ref name="Richens" | *''K. granulomatis'' may disseminate causing extragenital lesions in the following areas:<ref name="Richens" /> | ||
:*mouth | :*[[Mouth (human)|mouth]] | ||
:*cheek | :*[[cheek]] | ||
:*neck | :*[[neck]] | ||
:*pharynx | :*[[pharynx]] | ||
:*larynx | :*[[larynx]] | ||
:*nose | :*[[nose]] | ||
:*thorax | :*[[thorax]] | ||
*''K. granulomatis'' may also disseminate to the abdomen, intestines, liver, lungs, uterus, and ovaries causing systemic infection.<ref name="VelhoSouza2008" | *''K. granulomatis'' may also disseminate to the [[abdomen]], [[Intestine|intestines]], [[liver]], [[Lung|lungs]], [[uterus]], and [[Ovary|ovaries]] causing systemic infection.<ref name="VelhoSouza2008" /> | ||
==Complications== | ==Complications== | ||
* Genital damage and scarring | * Genital damage and scarring | ||
*[[Elephantiasis]]-like swelling | *[[Elephantiasis]]-like swelling<ref name="Richens" /> | ||
*[[Phimosis]] in men | *[[Phimosis]] in men | ||
*[[Strictures]] or [[fistulas]] of the [[urethra]], [[vagina]], or [[anus]] | *[[Strictures]] or [[fistulas]] of the [[urethra]], [[vagina]], or [[anus]]<ref name="VelhoSouza2008" /> | ||
*[[Coinfection]] with other [[sexually transmitted infections]] including: [[syphillis]], [[chancroid]], and [[Human Immunodeficiency Virus (HIV)]] | *[[Coinfection]] with other [[sexually transmitted infections]] including: [[syphillis]], [[chancroid]], and [[Human Immunodeficiency Virus (HIV)]] | ||
*[[Carcinoma]] (in 0.25% of cases)<ref name="O'Farrell" /> | |||
==Prognosis== | ==Prognosis== | ||
*Treating this disease early decreases the chances of tissue damage or scarring. Untreated disease leads to damage of the genital tissue. | *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. | *Donovanosis may reoccur after 6 to 18 months even after successful treatment.<ref name="VelhoSouza2008"></ref> | ||
==References== | ==References== | ||
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[[Category:Sexually transmitted infections]] | [[Category:Sexually transmitted infections]] | ||
[[Category:Bacterial diseases]] | [[Category:Bacterial diseases]] | ||
[[Category:Disease]] | [[Category:Disease]] | ||
{{WikiDoc Help Menu}} | {{WikiDoc Help Menu}} | ||
{{WikiDoc Sources}} | {{WikiDoc Sources}} | ||
Latest revision as of 17:36, 18 September 2017
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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
The incubation period of Klebsiella granulomatis is debated and ranges from 1 to 360 days with a median time of 50 days. Donovanosis starts as a papule or subcutaneous nodule which eventually ulcerates. The ulcer progresses to create areas of granulomatous tissue. Pseudoepitheliomatous hyperplasia of lesion borders often occurs. Ulcers autoinoculate creating multiple lesions. "Pseudobuboes" may also develop. Chronic ulcers leads to fibrosis and eventually Elephantiasis-like swelling. K. granulomatis may disseminate causing extragenital lesions and systemic infection. Complications include: genital damage and scarring, elephantiasis, phimosis in men, [strictures]] or fistulas of the urethra, vagina, or anus, foinfection with other sexually transmitted infections and carcinoma (in 0.25% of cases). Prognosis is poor without treatment because the disease has a high morbidity; untreated disease leads to damage of the genital tissue, scarring, and elephantiasis. Donovanosis may reoccur after 6 to 18 months after treatment.
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, often occurs.
- Ulcers may autoinoculate creating multiple lesions.
- "Pseudobuboes" may develop, which are nodular lesions that resemble lymphadenitis.[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]
- K. granulomatis may also disseminate to the abdomen, intestines, liver, lungs, uterus, and ovaries causing systemic infection.[3]
Complications
- Genital damage and scarring
- Elephantiasis-like swelling[4]
- Phimosis in men
- Strictures or fistulas of the urethra, vagina, or anus[3]
- Coinfection with other sexually transmitted infections including: syphillis, chancroid, and Human Immunodeficiency Virus (HIV)
- Carcinoma (in 0.25% of cases)[2]
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 even after successful treatment.[3]
References
- ↑ 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.
- ↑ 2.0 2.1 O'Farrell N (2002). "Donovanosis". Sex Transm Infect. 78 (6): 452–7. PMC 1758360. PMID 12473810.
- ↑ 3.0 3.1 3.2 3.3 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.
- ↑ 4.0 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.