Granuloma inguinale

There are different types of genital ulcers. In this article, a type of these wounds called “inguinal granuloma” and is a type of sexually transmitted diseases, is introduced.

In the following, we will describe the symptoms and ways to treat inguinal granuloma, which is a type of painless wound in the genital area and also affects the anus.

Inguinal granuloma, in addition to involving the anus and external genitalia, can spread into the pelvis or involve the abdominal organs. Sometimes the bones and mouth become infected with the inguinal granuloma.

Another name for inguinal granuloma is Donovanosis

 

 

What causes inguinal granuloma?

An intracellular gram-negative bacterium called Klebsiella granulomatis is an infectious agent that causes inguinal granuloma. These bacteria are also known as Calymmatobaccterium.

 

In which areas is granuloma more common?

It is a sexually transmitted disease that is prevalent in cold and developed countries but is common in tropical and developing countries and developing countries.

 

Symptoms of inguinal granuloma

Primary skin lesion occurs at the site of contact, this lesion is initially in the form of a pimple or small protrusion (papule or subcutaneous nodule); over time the lesion becomes injured

The lesion affects men around the anus and penis and in women in the labia, especially the labia minora and other areas of the external genitalia.

 

Types of inguinal granules

Below we introduce and explain the different clinical types of inguinal granuloma.

Ulcerovegetative type:

The most common clinical type of this disease is a type that causes ulcers and has the following special features:

• One or more small, prominent lesions form in the area that comes in contact with the infected person’s lesions.
• These lesions are easily scratched and cause local bleeding.
• These sores are generally painless.
• The margins of these wounds are clear.
• They are not purulent.
• In the parts of the genital area that are wrinkled, the wounds are placed in a line in a row, which is called a knife cut.
• If left untreated, these sores or lesions will become larger without pain.

Hypertrophic type (wart-like) (verrucous):

They are large, wart-like lesions that sometimes resemble walnuts in appearance.

Nodular type:

This type is less common and includes lesions similar to soft and red pimples.

Necrotic type:

Wounds in this type are very smelly

Scar type (cicatricial):

These types of inguinal granuloma lesions leave scars on their own.

 

Latency period (commune) of inguinal granuloma

We said that this disease is a sexually transmitted disease, it is not yet exactly clear how many days after sexual contact with the infected person, symptoms occur, but usually the incubation period is about fifty days.

Of course, a commune period of less than this period (within a few days) or more than this period (within a year after contact) has also been reported.

 

What are the complications of inguinal granuloma?

The complications of this sexually transmitted disease are as follows:

• Chronic and prolonged lesions cause scratching and bleeding
• Wounded lesions become infected
• Swelling of the area is caused by a blockage in the lymphatic vessels called lymphedema.
• Lesions can leave permanent scars
• In addition to leaving scars, the affected skin sometimes develops clear or pale skin spots.

 

Diagnosis of inguinal granuloma

As inguinal granuloma is a lesion that has different clinical forms and types, it is necessary to differentiate it with the following:

1. In the early stages, it can be confused with chancroid ulcers
2. In the final and advanced stages of lymphedema, it can be mistaken for lymphogranulomavenereum (a sexually transmitted disease that affects the lymph nodes and genitals).
3. In cases where the sores are on the penis and labia, they are sometimes confused with penile cancers.

For accurate diagnosis, a sampling of the wound is performed, and then a tissue sample with Giemsa staining is prepared under a microscope,

Under the microscope, inside the cells involved, a series of specific objects called (Donovan) objects Which are specific to the inguinal granuloma, are seen.

We do not usually use culture media or serology to diagnose this disease.

 

People at risk for granuloma

The following two groups of people have a high chance of developing granuloma:

1. people who have a lot of sexual activity with multiple partners
2. babies born from the vagina of the affected mother

 

Treatment of inguinal granuloma

We said that the causative agent of inguinal granuloma is a bacterium, so the use of antibiotics in its treatment will be useful.

The recommended treatment is:

Take one gram of antibiotics a week for three weeks or more

These antibiotics include the following:

• Doxycycline
• Erythromycin
• Cotrimoxazole

(With gentamicin)

Tip:

The minimum duration of treatment is three weeks, treatment should continue until the wound is completely healed and the patient should not have any sexual contact during treatment. Antibiotics are essential to prevent a baby born to an infected mother

The only way to prevent inguinal granuloma is to avoid having sex with multiple and suspicious sexual partners.