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Latest revision as of 17:36, 18 September 2017

Donovanosis Microchapters

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Overview

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Pathophysiology

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Classification

Differentiating Donovanosis from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Nate Michalak, B.A.

Overview

Donovanosis must be differentiated from other diseases that cause genital ulcers without lymphadenopathy including: primary or secondary syphilis, chancroid, herpes simplex, amoebiasis, and squamous cell carcinoma. Sexually transmitted diseases characterized as genital ulcer diseases may present with similar manifestations and lesion characteristics.

Differentiating Donovanosis from Other Diseases

Donovanosis must be differentiated from other diseases that cause genital ulcers without lymphadenopathy:[1]

Other diseases that causes specifically granulomatous ulcers include:

Sexually transmitted diseases characterized as genital ulcer diseases may present with similar manifestations and lesion characteristics. A diagnosis based only on the patient’s medical history and physical examination frequently is inaccurate. Patients who have genital, anal, or perianal ulcers should be evaluated with laboratory tests to make a definitive diagnosis.[2]

Clinical Characteristic Sexually Transmitted Disease
Chancroid Genital Herpes Donovanosis LGV Syphilis
Cause Haemophilus ducreyi Herpes Simplex Virus (HSV-1 & HSV-2) Klebsiella granulomatis Chlamydia trachomatis serovars L1, L2, or L3 Treponema pallidum
Lesion Type Papule evolving to ulcer Vesicle evolving to ulcer Ulcer progressing to granuloma Self-limited papule or ulcer Papule evolving to ulcer
Lesion Border Crater with irregular, sharp margins Circular, sharp margins on erythematous base Friable base with sharp, raised, rolled margin Shallow, smooth border Crater with raised edges, smooth margins
Lesion Distribution Single or multiple Multiple, in group/crop Single or multiple Single or herpetiform Multiple
Lesion Texture Soft Umbilicated Granulomatous Firm bump Indurated
Lesion Tenderness Present Present Absent Absent Absent
Lesion Exudate Grey/yellow purulent exudate Non-exudative Non-exudative but bleeds easily Non-exudative Non-exudative; non-fluctuant
Lymphadenopathy Present and tender in approx. half of patients (typically unilateral) Present and tender Absent from primary infection; pseudobuboes may occur Present and tender Present and non-tender (uni- or bilateral)

References

  1. O'Farrell N (2002). "Donovanosis". Sex Transm Infect. 78 (6): 452–7. PMC 1758360. PMID 12473810.
  2. 2015 Sexually Transmitted Diseases Treatment Guidelines. Centers for Disease Control and Prevention (June 4, 2015). http://www.cdc.gov/std/tg2015/genital-ulcers.htm Accessed February 18, 2016.


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