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07-SEPTEMBER-2008 03:17:44 - Donovanosis Wikimedia Commons has media related to: Donovanosis Medical Classifications Classification and external resources ICD-10 A58. ICD-9 099.2 Calymmatobacterium granulomatis Scientific classification Kingdom: Bacteria Phylum: Proteobacteria Class: Gamma Proteobacteria Order: Enterobacteriales Family: Enterobacteriaceae Genus: Calymmatobacterium or Klebsiella Species: granulomatis Donovanosis, also known as granuloma inguinale, is a bacterial disease that has reached endemic proportions in many underdeveloped regions. Because of the scarcity of medical treatment, the disease often goes untreated. The disease is characterized by painless genital ulcers which can be mistaken for syphilis.1 However, they ultimately progress to destruction of internal and external tissue, with leakage of mucus and blood. The destructive nature of donovanosis also increases the risk of superinfection by other pathogenic microbes. Contents 1 Classification 2 Symptoms 3 Transmission 4 Diagnosis 5 Treatment 6 Prevention 7 References 8 Further reading 9 External links Classification The proper clinical designation for donovanosis is granuloma inguinale.2 Granuloma is a nodular type of inflammatory reaction, and inguinale refers to the inguinal region, which is commonly involved in this infection. The disease is commonly known as donovanosis, after the Donovan Bodies which are a diagnostic sign. Discovered by a researcher named Donovan, these intracellular inclusions represent bacteria that have been engulfed by scavenger cells called mononuclear phagocytes or histiocytes. The causative organism, Klebsiella granulomatis, used to be called Calymmatobacterium granulomatis some source still use this classification3, from the Greek kalymma a hood or veil, referring to the lesions that contain the bacteria. Prior to this it was called Donovania granulomatis, named after the Donovan Bodies.4 The species name granulomatis refers to the granulomatous lesions. The organism was recently reclassified under the genus Klebsiella, a drastic taxonomic change, since it involved changing the organism's phylum. However, polymerase chain reaction PCR techniques using a colorimetric detection system showed a 99% similarity with other species in the Klebsiella genus.citation needed Symptoms Donovanosis of the penis. Donovanosis of the penis. 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 perianal region. Rarely, the vaginal wall or cervix is the site of the lesion. Transmission The microorganism spreads from one host to another through contact with the open sores. Oral, vaginal or anal intercourse are high risk behaviors to engage in with someone who is infected. Diagnosis The patient's sexual history is requested. Experienced doctors are able to diagnose donovanosis by only looking at the ulcers. However, it may be necessary for the health care provider to take a sample of tissue in order to correctly diagnose the disease. He or she may decide to add a Wright-Giemsa stain in order to better view the cells. Additionally, the presence of Donovan bodies in the tissue sample confirms donovanosis. Treatment Three weeks of treatment with erythromycin, streptomycin, or tetracycline, or 12 weeks of treatment with ampicillin are standard forms of therapy. Normally, the infection will begin to subside within a week of treatment, however, the full treatment period must be followed in order to minimize the possibility of relapse. Prevention The disease is effectively treated with antibiotics, therefore, developed countries, like the United States, have a very low incidence of donovanosis, approximately 100 cases reported each year in the United States. However, sexual contacts with individuals in endemic regions dramatically increases the risk of contracting the disease. Avoidance of these sexual contacts, and STD testing before beginning a sexual relationship are effective preventative measures for donovanosis. References ^ Murray P. et al. 2005, Medical Microbiology, fifth ed., Elsevier Mosby, p. 336. ^ Murray P. et al. 2005, Medical Microbiology, fifth ed., Elsevier Mosby, p. 336. ^ granuloma inguinale at Dorland's Medical Dictionary ^ Murray P. et al. 2005, Medical Microbiology, fifth ed., Elsevier Mosby, p. 336. Further reading Boyea, Kit; Hansen, Dennis S. 2003. Sequencing of 16S rDNA of Klebsiella: taxonomic relations within the genus and to other Enterobacteriaceae. International Journal of Medical Microbiology 292 7-8: 495-503. doi:10.1078/1438-4221-00228. Carter, Jenny S.; et al. 1999. Phylogenetic evidence for reclassification of Calymmatobacterium granulomatis as Klebsiella granulomatis comb. nov.. International Journal of Systematic Bacteriology 49 4: 1695-1700. doi:10.1099/00207713-49-4-1695. O'Farrell, N. 2002. Donovanosis. Sexually Transmitted Infections 78 6: 452-457. doi:10.1136/sti.78.6.452. Gavin Hart MD, MPH Transcript of the lecture given at the Australian Society for Infectious Diseases/Australasian College of Tropical Medicine Conference at Palm Cove Cairns, Queensland on 19 April 1999. 2001 National Guideline for the management of Donovanosis granuloma inguinale Association for Genitourinary Medicine and the Medical Society for the study of Venereal Diseases External links Medline Plus description of Donovanosis Granuloma inguinale eMedicine description Research supporting Klebsiella Genus classification http://www.epigee.org/health/granu_ingui.html http://www.nlm.nih.gov/medlineplus/ency/article/000636.htm http://www.healthatoz.com/healthatoz/Atoz/ency/granuloma_inguinale.jsp http://www.indepthlearning.org/std/STDnew.php/76C.html http://www.stdservices.on.net/publications/pdf/donovanosis.pdf http://www.fasthealth.com/dictionary/c/Calymmatobacterium.php Resource Library:Granuloma inguinale http://www.bacterio.cict.fr/e/enterobacteriaceae.html http://www.mansfield.ohio-state.edu/~sabedon/biol3018.htm http://www.dscc.edu/bwilliams/Biology/Monera.htm http://www.sidwell.edu/us/science/vlb5/Labs/Classification_Lab/classification_lab.html v d e Sexually transmitted diseases and infections STD/STI primarily A50-A64, 090-099 Bacterial Chancroid Haemophilus ducreyi Chlamydia Chlamydia trachomatis Donovanosis Granuloma Inguinale Lymphogranuloma venereum LGV Gonorrhea Neisseria gonorrhoeae Syphilis Treponema pallidum Ureaplasma urealyticum Protozoal Trichomoniasis Trichomonas vaginalis Parasitic Crab louse/crabs Scabies Viral AIDS HIV-1/HIV-2 Cervical cancer Genital warts condyloma Human papillomavirus HPV Hepatitis B Herpes simplex virus HSV1/HSV2 Molluscum contagiosum MCV General inflammation female: Cervicitis Pelvic inflammatory disease PID male: Epididymitis Prostatitis either: Proctitis Urethritis/Non-gonococcal urethritis NGU Other Ectopic pregnancy Premature birth Infertility Reactive arthritis v d e Infectious diseases - Bacterial diseases primarily A00-A79, 001-041,080-109 G+ Firmicutes Clostridium Pseudomembranous colitis - Botulism - Tetanus - Gas gangrene Bacilli class Coccus Strep-: Alpha pneumoniae, mutans, viridans - Beta A pyogenes Scarlet fever, Erysipelas, Rheumatic fever, Streptococcal pharyngitis, B agalactiae - D Entero- Staphylo- - Toxic shock syndrome Bacillus shape Bacillus Anthrax - Listeria Listeriosis Actinobacteria Actinomycetales Actinomycosis/Actinomycetoma Whipple's disease - Corynebacterium Diphtheria, Erythrasma - Nocardia Nocardiosis, Maduromycosis Mycobacterium M. tuberculosis Tuberculosis: Ghon focus/Ghon's complex - Pott disease - brain Meningitis, Rich focus - cutaneous Scrofula, Bazin disease, Lupus vulgaris, Prosector's wart - Miliary M. leprae Leprosy Nontuberculous: Mycobacterium avium Lady Windermere syndrome - Mycobacterium ulcerans Buruli ulcer G- Spirochetal Treponema: Syphilis Bejel - Yaws - Pinta Borrelia: Relapsing fever - Lyme disease Erythema chronicum migrans, Neuroborreliosis other/multiple/unknown: Noma - Trench mouth - Rat-bite fever Sodoku - Leptospirosis Intracellular Mycoplasmatales Mycoplasma pneumonia - Ureaplasma infection Chlamydiae Chlamydophila Psittacosis - Chlamydia Chlamydia, Lymphogranuloma venereum, Trachoma Proteobacteria primarily rods, except Neisseria =cocci α/ Intra- Rickettsiales/ Rickettsioses/ Anaplasmataceae Typhus Murine typhus, Epidemic typhus spotted fever Rocky Mountain spotted fever, Boutonneuse fever, Rickettsialpox Ehrlichiosis Human granulocytic ehrlichiosis, Human monocytic ehrlichiosis OTHER: Coxiella Q fever - Bartonella Trench fever - Orientia Scrub typhus Rhizobiales Brucellosis - Cat scratch fever - Bartonellosis Bacillary angiomatosis β Neisseriaceae: Meningococcus Meningococcal disease, Waterhouse-Friderichsen syndrome - Gonorrhea Burkholderiales: Glanders - Melioidosis - Pertussis γ Enterobacteriaceae: Salmonella Typhoid fever, Paratyphoid fever, Salmonellosis - Yersinia pestis Plague/Bubonic plague - Klebsiella Rhinoscleroma, Donovanosis - Shigella Shigellosis - Escherichia coli/O157:H7 - Proteus Pasteurellaceae: Pasteurella Pasteurellosis - Haemophilus Brazilian purpuric fever, Chancroid - Actinobacillus Actinobacillosis other: Francisella Tularemia - Vibrio Cholera - Legionella Legionellosis - Pseudomonas - Serratia ε Campylobacteriosis - Helicobacter Bacteroidetes Bacteroides Other Gardnerella Retrieved from http://en..org/wiki/Donovanosis Categories: Sexually transmitted diseases and infections | Bacterial diseasesHidden categories: All articles with statements | Articles with statements since April 2008 Views Article Discussion this page History Personal tools Log in / create account Navigation Main page Contents Featured content Current events Random article Search Go Search Interaction Community portal Recent changes Contact Donate to Help Toolbox What links here Related changes Upload file Special pages Printable version Permanent link Cite this page Languages Italiano Polski Türkçe This page was last modified on 19 August 2008, at 10:28
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