Granuloma Inguinale

Granuloma Inguinale

Granuloma inguinale or donovanosis is a sexually transmitted infection caused by the bacterium  Klebsiella granulomatis . This disease usually occurs in people who are sexually active , both vaginal and anal.

Granuloma inguinale is characterized by the appearance of small, painless red lumps in the genital area. This lump increases in size slowly, then breaks and forms a wound. If left untreated, these sores can become permanent scars.

Granuloma inguinale is a type  of sexually transmitted infection  that is quite rare. This disease is usually found in people aged 20–40 years and are sexually active. Granuloma inguinale is also more common in men than women.

Causes of Granuloma Inguinale

Granuloma inguinale is caused by the bacterium  Klebsiella granulomatis . A person can be infected by this bacterium through sex through the vagina (vaginal) and through the anus ( anal ). In rare cases, this bacterium can also be transmitted through sex through the mouth (oral).

Granuloma inguinale is also known to occur more often in men than women. Therefore, people with male sex behavior (MSM) are more susceptible to contracting granuloma inguinale than heterosexual people. Granuloma inguinale is also more common in tropical and subtropical regions.

Like other sexually transmitted diseases, granuloma inguinale can also occur in rape victims .

Granuloma Inguinale Symptoms

Symptoms of granuloma inguinale appear and develop slowly. Typically, the time span from transmission to symptoms appearing is 1–12 weeks.

The initial symptom of granuloma inguinale is a reddish lump that appears in the groin area. These lumps are small and painless, so they are often not noticed by the sufferer. In patients who have anal or oral sex, lumps may also appear in the anal area or face.

Symptoms of granuloma inguinale develop in three stages, namely:

The first stage

At this stage, the lump will spread to areas beyond the groin. The lump will be enlarged, prominent, and looks red like growing flesh. Although not painful, this lump bleeds easily when rubbed.

Second stage

Entering the second stage, bacteria begin to damage the skin, forming open sores in the groin that cause an unpleasant odor. In men, these open sores can appear on the penis, scrotum, and groin. Whereas in women, sores can form on the vulva, vagina , and the surrounding area.

Third phase

In the third stage, the wound that forms gets deeper and forms scar tissue around the groin. Granuloma inguinale can also spread to the lymph nodes in the groin and cause the area to swell. In addition, the infection can also spread to the bones, joints and liver, through the bloodstream.

When to see a doctor

Immediately consult  a doctor  if complaints appear as mentioned above. You should also be tested if you have a sexual partner who is known to have granuloma inguinale.

Check for sexually transmitted infections to your doctor regularly if you are sexually active, often change partners, or have sex without using a condom .

Diagnosis of Granuloma Inguinale

The symptoms of granuloma inguinale are similar to those of  lymphogranuloma vereneum  (LGV), chancroid , syphilis, penile cancer, and  vulvar cancer . Therefore, this disease is difficult to diagnose.

Diagnosis begins with a question and answer regarding the patient's history of sexual intercourse. Next, the doctor will do a physical examination, especially in the genital area.

Usually, patients are suspected of suffering from this disease after an open wound appears in the groin area, especially if the wound does not heal. However, to be sure the doctor will take a tissue sample (biopsy) from the patient's wound to detect the presence of  Klebsiella granulomatis bacteria .

Granuloma Inguinale Treatment

Treatment of granuloma inguinale should be started early to prevent swelling and the formation of permanent scar tissue around the genitals. The doctor will give antibiotics in the form of drinking or injection for 3 weeks. The types of antibiotics given include:

  • Trimethoprim-sulfamethoxazole
  • Doxycycline
  • Erythromycin
  • Ciprofloxacin
  • Azithromycin
  • Gentamicin

Patients generally improve within 7 days after treatment. However, if the infection has spread to the lymph nodes in the groin, the healing process may take longer. Lumps can also grow back so that the patient must undergo treatment until the doctor says he is cured.

During the healing process, the patient should not have sexual intercourse. Patients are also required to regularly see a doctor for up to 6 months after recovery. In addition, the patient's partner must also undergo examination and treatment if they experience similar symptoms.

Granuloma Inguinale Complications

Complications that can arise from granuloma inguinale or donovanosis include:

  • Changes in skin color in the groin area
  • Permanent damage or scar tissue formation in the genitals
  • Permanent swelling in the genitals due to scar tissue
  • Spread of infection to other organs, such as bones, joints, or liver
  • Blockage of lymph nodes around the genitals
  • Swelling and joint pain
  • Long-term (chronic) pain
  • Recurrent granuloma inguinale infection

Prevention of Granuloma Inguinale

As explained above, granuloma inguinale can be transmitted through sexual contact. Therefore, the main way to prevent this disease is to have safe sex, namely by using a condom and not having multiple sexual partners.

In addition, men and women who are sexually active are advised to routinely undergo screening for sexually transmitted diseases. This is a form of prevention so that sexually transmitted diseases can be diagnosed and treated earlier.

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