Granuloma inguinale is a genital ulcerative disease caused by the intracellular gram-negative bacterium Klebsiella granulomatis (formerly. J Clin Microbiol. Nov;35(11) Culture of the causative organism of donovanosis (Calymmatobacterium granulomatis) in HEp-2 cells. Carter J(1). Klebsiella granulomatis (Granuloma inguinale, Donovanosis) answers are found in the Johns Hopkins ABX Guide powered by Unbound Medicine. Available for.
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Spread to local lymph nodes is followed by ulceration of skin overlying the lymph nodes.
The ulcers are characterized by slow growth, absence calymmatobacterium granulomatis pain and friability. Hypertrophic lesions which stand out from the surrounding skin are common. Primary oral lesions have been described.
Calymmatobacterium granulomatis women, lesions may involve the cervix and upper reproductive tract.
Calymmatobacterium granulomatis include tissue destruction, scarring, the calymmatobacterium granulomatis of genital lymphoedemahaematogenous dissemination to bones and viscera and squamous carcinoma.
Laboratory Diagnosis There are no established protocols for routine isolation and antibiotic susceptibility testing of C. The diagnosis of donovanosis depends primarily on demonstrating the presence of intracellular organisms termed Donovan bodies in large mononuclear cells as Gram calymmatobacterium granulomatis intracytoplasmic cysts filled with deeply staining bodies that may have a safety pin appearance Polymerase chain reaction PCR analysis using a colorimetric detection system can now be used in routine diagnostic laboratories and a genital ulcer multiplex PCR that includes C.
Calymmatobacterium granulomatis | bacillum |
It has been suggested that the inability of C. A granulomatous inflammatory response is seen which leads to local tissue destruction and cutaneous ulceration. Numerous unsuccessful attempts have been made to find an animal calymmatobacterium granulomatis for donovanosis.
In DeMonbreun et al. It has not been possible so far to assess antibiotic activity against C. The logical calymmatobacterium granulomatis of therapy is thus an antibiotic with good activity against Gram negative bacteria, with good lipid solubility and capable of achieving a high intracellular to extracellular concentration ratio.
Relapse may occur if treatment is taken for too short a time. Donovanosis may in the future prove a suitable infection for treatment with liposome-encapsulated antibiotics.
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Drug of Choice Table 2 summarizes data from the calymmatobacterium granulomatis important therapeutic trials. For a comprehensive bibliography of drug trials for donovanosis up to readers are referred to a review paper Drugs of the tetracycline group have been used extensively in the treatment of donovanosis for many years, generally with excellent results.
Many published guidelines for the treatment of donovanosis e. Individual well-documented cases of tetracycline resistance have been reported 35 and the drug appeared ineffective in infections contracted in Vietnam It may be assumed that the different forms of tetracycline have equivalent efficacy.
Doxycycline is now generally preferred over alternatives for ease of administration twice daily. Excellent results with co-trimoxazole have been reported from India 26 and Africa Two treatment failures with co-trimoxazole have been reported from South America Chloramphenicol is widely used for treatment of donovanosis in Papua New Guinea 30generally with good results.
Lengthy experience with the use of chloramphenicol calymmatobacterium granulomatis a variety of infections in Papua New Guinea has shown that haematological toxicity is rare in this population. While chloramphenicol may be considered a treatment of choice in Melanesians, concerns about potential toxicity would limit its use elsewhere.
Recent work from South America suggests that thiamphenicol, a congener of chloramphenicol, which has the convenience of once daily administration and reputedly does not carry the risk of haematological toxicity, is of comparable calymmatobacterium granulomatis 5.
C eftriaxone can give good results in chronic relapsing cases which have failed to respond a variety of other calymmatobacterium granulomatis