GRANULOMA INGUINALE

GRANULOMA INGUINALE:
     Granuloma inguinale is a sexually transmitted infection caused by a bacterial infection, characterized by ulcerative genital lesions. This sexually transmitted infection causes bumps and blisters to form on the genitalia, which, if left untreated, can destroy genital tissues and organs. It is also known as "donovanosis, granuloma genitoinguinale, granuloma inguinale tropicum, granuloma venereum, granuloma venereum genitoinguinale, lupoid form of groin ulceration, serpiginous ulceration of the groin, ulcerating granuloma of the pudendum and ulcerating sclerosing granuloma."

CAUSES:
      The infection is caused by the bacteria "Klebsiella granulomatis", used to be called "Calymmatobacterium granulomatis."
    
MODE OF TRANSMISSION:  

• Unprotected sexual contact (including, vaginal, anal and Very rarely during oral sex)
• Spreads from one host to another through contact with the open sores (by touching the sores)
• Can be passed by the mother to her baby by vaginal childbirth 
• having multiple sex partners
• being male (men are twice as likely to contract granuloma inguinale)
• being between the ages of 20 and 40

SYMPTOMS:
   
     Small, painless nodules appear after about 10–40 days of the contact with the bacteria. Later the nodules burst, creating open, fleshy, oozing lesions. The infection spreads, mutilating the infected tissue. The infection will continue to destroy the tissue until treated. The lesions occur at the region of contact typically found on the shaft of the penis, the labia, or the perineum. Rarely, the vaginal wall or cervix is the site of the lesion.

• rectal discomfort
• diarrhea
• upset stomach
• About half of infected men and women have sores in the anal area.
• Small, beefy-red bumps appear on the genitals (penis on male, vagina / labia on female) and around the anus.
• The skin gradually wears away, and the bumps turn into raised, beefy-red, velvety nodules called granulation tissue. They are usually painless, but they bleed easily if injured.
•  The disease slowly spreads and destroys genital tissue.
•  Tissue damage may spread to the area where the legs meet the torso. This area is called the inguinal folds.
•  The genitals and the skin around them lose skin color.

     In its early stages, it may be hard to tell the difference between donovanosis, chancroid and syphilis, however, after a few weeks they begin to change in size and appearance. The bumps gradually increase in size and begin to eat away at the genital tissue, causing scarring and destruction..

     In the later stages, donovanosis may look like advanced genital cancers, lymphogranuloma venereum, and anogenital cutaneous amebiasis.

     If left untreated, granuloma inguinale can cause some serious health complications, including:
   
    Genital damage and scarring
    Permanent genital swelling due to scarring
    Loss of skin color in genital area
    Swelling of the subcutaneous tissue in the groin region
     
  
PREVENTION:
    
     Granuloma Inguinale is spread by sexual contact with an infected person. Avoiding all forms of sexual activity is the only absolute way to prevent from being infected.
     However, safe sex practices may reduce your risk. The proper use of latex condoms, either the male or female type, greatly decreases the risk of catching a sexually transmitted disease. You need to wear the condom from the beginning to the end of each sexual activity.
      
Treatment:

     Granuloma Inguinale may be treated with the right medicines prescribed by the doctors it may take up to 3 weeks until the sore is completely healed. 
     Follow up examination is important because it may reappear after it seems to be cured.
     Treatment failure is possible with HIV co-infection and extended therapy is sometimes required.
     
IMPORTANT NOTE:

• Do not self-medicate on any kind of Sexually Transmitted Infections
• Have yourself tested if you have symptoms of Granuloma Inguinale
• If you had sexual contact with a person known to have STIs.
• If you are engaging in high-risk sexual practices.

PROGNOSIS:

     Prognosis is excellent with proper treatment. Treating sexual contacts of affected individual helps break cycle of infection.









Sources:
Fishbein's Illustarted Medical and Health Encyclopedia
www.wikipedia.org
www.epigee.org 
www.nlm.nih.gov/medicineplus