Klebsiella granulomatis - Revision history

Aidan: Text replacement - "[[Cellular shape::" to "[[Shape::"

2020-10-12T09:50:43Z

Text replacement - "[[Cellular shape::" to "[[Shape::"

← Older revision		Revision as of 09:50, 12 October 2020
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	===Microbiology===		===Microbiology===

	*[[Stain::Gram-negative]] [[~~Cellular shape~~::bacillus]]		*[[Stain::Gram-negative]] [[Shape::bacillus]]
	*Previously known as ''Donovania granulomatis'' and ''Calymmatobacterium granulomatis''		*Previously known as ''Donovania granulomatis'' and ''Calymmatobacterium granulomatis''

Aidan at 01:50, 8 August 2020

2020-08-08T01:50:14Z

← Older revision		Revision as of 01:50, 8 August 2020
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⚫	{{DISPLAYTITLE:''Klebsiella granulomatis''}}

	==Background==		==Background==

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	* 2016 European guideline on donovanosis. ''Int J STD AIDS''. 2016;27(8):605-607. doi: [https://doi.org/10.1177/0956462416633626 10.1177/0956462416633626]		* 2016 European guideline on donovanosis. ''Int J STD AIDS''. 2016;27(8):605-607. doi: [https://doi.org/10.1177/0956462416633626 10.1177/0956462416633626]

		⚫	{{DISPLAYTITLE:''Klebsiella granulomatis''}}

	[[Category:Gram-negative bacilli]]		[[Category:Gram-negative bacilli]]

Aidan at 01:50, 8 August 2020

2020-08-08T01:50:03Z

← Older revision		Revision as of 01:50, 8 August 2020
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	{{DISPLAYTITLE:''Klebsiella granulomatis''}}		{{DISPLAYTITLE:''Klebsiella granulomatis''}}

	== Background ==		==Background==

	* Also called granuloma inguinale or donovanosis		*Also called granuloma inguinale, donovanosis, granuloma venereum

	=== Microbiology ===		===Microbiology===

	* [[Stain::Gram-negative]] [[Cellular shape::bacillus]]		*[[Stain::Gram-negative]] [[Cellular shape::bacillus]]
	* Previously known as ''Donovania granulomatis'' and ''Calymmatobacterium granulomatis''		*Previously known as ''Donovania granulomatis'' and ''Calymmatobacterium granulomatis''

	=== Epidemiology ===		===Epidemiology===

	* ~~Essentially worldwide in low- and middle-income countries~~, ~~but~~ ~~high~~ ~~rates~~ in Papua New Guinea, KwaZulu-Natal and eastern Transvaal in South Africa, India, Brazil, and ~~among~~ Aboriginal ~~Australians~~		*Rare, with most cases in Papua New Guinea, KwaZulu-Natal and eastern Transvaal in South Africa, India, Brazil, and Aboriginal communities in Australia

	== Clinical Manifestation ==		==Clinical Manifestation==

	* Incubation period is unclear, possibly somewhere between [[Usual incubation period::~~3 to 40~~ days]] with a wide range from [[Incubation period range::1 to 360 days]]		*Incubation period is unclear, possibly somewhere between [[Usual incubation period::50 days]] with a wide range from [[Incubation period range::1 to 360 days]]
	* Presents as a firm papule or subcutaneous nodule that eventually ulcerates		*Presents as a firm papule or subcutaneous nodule that eventually ulcerates
	** Almost all in genitals, but 10% can be inguinal		**Almost all in genitals, but 10% can be inguinal
	** Case reports of extragenital lesions in lips, gums, cheeks, palate, pharynx, neck, nose, larynx, and chest		**Case reports of extragenital lesions in lips, gums, cheeks, palate, pharynx, neck, nose, larynx, and chest
	* Four types:		*Four types:
	** Ulcerogranulamatous: most common type, shows as a beefy red, non-tender ulcer that bleed		**Ulcerogranulamatous: most common type, shows as a beefy red, non-tender ulcer that bleed
	** Hypertrophic ~~or verrucous:~~ irregular edge, sometimes dry		**Hypertrophic: raised, irregular edge, sometimes dry
	** Necrotic: deep ulcer causing tissue destruction		**Necrotic: deep ulcer causing tissue destruction and foul odor
	** ~~Dry, sclerotic, or cicatricial~~: fibrous with scar tissue		**Sclerotic: fibrous with scar tissue
			*Rarely disseminates to liver and bone
			*Major complication is [[squamous cell carcinoma]]

	== Differential Diagnosis ==		==Differential Diagnosis==

	* Refer to [[genital ulcer disease]]		*Refer to [[genital ulcer disease]]
			*Also includes [[squamous cell carcinoma]] of the penis

			== Diagnosis ==

			* Direct microscopy
			** Swab rolled across lesion then across a slide
			** Stain with Giemsa, which should show large mononuclear cells with intracytoplasmic cysts fillwed with Gram-negative Donovan bodies
			* Culture not available
			* PCR where available
			* Serology not reliable

			== Management ==

			* Test for other [[Sexually-transmitted infection\|sexually-transmitted infections]]
			* [[Is treated by::Azithromycin]] 1 g PO weekly (or 500 mg PO daily) for at least 3 weeks and until lesion is healed
			** Second-line is [[TMP-SMX]] 160/800 mg PO bid or [[doxycycline]] 100 mg PO bid
			** In pregnancy, can use [[erythromycin]] 500 mg PO qid
			** Can add adjunctive [[gentamicin]] 1 mg/kg q8h if the lesion is slow to heal
			** In children, [[azithromycin]] 20 mg/kg
			* If it does not heal, it may need biopsy to exclude [[squamous cell carcinoma]]

			== Prevention ==

			=== Neonatal Infection ===

			* To prevent neonatal acquisition, children born to mothers with donovanosis should be prophylactically treated with [[azithromycin]] 20 mg/kg PO daily for 3 days

			== Further Reading ==

			* 2016 European guideline on donovanosis. ''Int J STD AIDS''. 2016;27(8):605-607. doi: [https://doi.org/10.1177/0956462416633626 10.1177/0956462416633626]

	[[Category:Gram-negative bacilli]]		[[Category:Gram-negative bacilli]]

Aidan: Created page with "{{DISPLAYTITLE:''Klebsiella granulomatis''}} == Background == * Also called granuloma inguinale or donovanosis === Microbiology === * Stain::Gram-negative Cellular s..."

2020-08-08T01:33:18Z

Created page with "{{DISPLAYTITLE:''Klebsiella granulomatis''}} == Background == * Also called granuloma inguinale or donovanosis === Microbiology === * Stain::Gram-negative Cellular s..."

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{{DISPLAYTITLE:''Klebsiella granulomatis''}}

== Background ==

* Also called granuloma inguinale or donovanosis

=== Microbiology ===

* [[Stain::Gram-negative]] [[Cellular shape::bacillus]]
* Previously known as ''Donovania granulomatis'' and ''Calymmatobacterium granulomatis''

=== Epidemiology ===

* Essentially worldwide in low- and middle-income countries, but high rates in Papua New Guinea, KwaZulu-Natal and eastern Transvaal in South Africa, India, Brazil, and among Aboriginal Australians

== Clinical Manifestation ==

* Incubation period is unclear, possibly somewhere between [[Usual incubation period::3 to 40 days]] with a wide range from [[Incubation period range::1 to 360 days]]
* Presents as a firm papule or subcutaneous nodule that eventually ulcerates
** Almost all in genitals, but 10% can be inguinal
** Case reports of extragenital lesions in lips, gums, cheeks, palate, pharynx, neck, nose, larynx, and chest
* Four types:
** Ulcerogranulamatous: most common type, shows as a beefy red, non-tender ulcer that bleed
** Hypertrophic or verrucous: irregular edge, sometimes dry
** Necrotic: deep ulcer causing tissue destruction
** Dry, sclerotic, or cicatricial: fibrous with scar tissue

== Differential Diagnosis ==

* Refer to [[genital ulcer disease]]

[[Category:Gram-negative bacilli]]
[[Category:Infectious diseases]]