Donovanosis A58.x0

The causative agent is Klebsiella granulomatosis, formerly known as Calymmatobacterium granulomatis or Donovania granulomatis, an encapsulated gram-negative rod (see below Klebsiella). Taxonomically, the pathogen is assigned to the Klebsiellae. It lives intracellularly (leukocytes, histiocytes; plasma cells). Culture is possible (yolk sac), but is considered difficult. Transmission through sexual intercourse.

Endemic to India, the Caribbean, Brazil, the west coast of Africa, the South Pacific Islands. Sporadically also in Europe, North America.

After an incubation period of 1-12 weeks, development of non-painful, itchy pustules, papules or nodules. In the further course, increasing confluence and ulcerous decay, formation of soft, slightly bleeding, hypertrophic granulations with velvety, light red, later also yellowish smeary surface. Continuous spread of the painless, beet-like vegetations towards the groins. If not treated, abscess formation often occurs. Lymph node swellings (bubones) are atypical. Rarely, the development of lymphedema of the penis, scrotum or labia is possible due to obstruction of the lymphatic channels, especially as a result of secondary infections. In MSM, anal infestation is possible.

Notice!

Cotrimoxazole (e.g. Cotrimox-Wolff) 4 times/day 500 mg p.o. for 2-4 weeks until the lesion is completely healed. Alternatively: Tetracycline (e.g. Tetracycline Heyl 500) 4 times/day 500 mg p.o. or Doxycycline (e.g. Doxycycline Stada 100) 2 times/day 100 mg p.o. Alternatively: Azithromycin (Zithromax) 1 time / week 1 g p.o. for at least 3 weeks.

In pregnancy: Erythromycin (e.g. Erythromycin 500 Heumann) 4 times/day 500 mg p.o. or i.v. for 3 weeks.

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