Therefore, they concluded that C. This organism is a Gram-negative facultative aerobic bacteria, apparently an intestinal saprophyte and possibly opportunistic, which depending on individual susceptibility or bacteriophage action can penetrate the tegument and cause the disease. A varying number of these ulcers can be observed and may sometimes be multiple, and they are chronic and usually not associated with regional lymphadenopathy.
History Microbiology Calymmataobacterium granulomatis is an intracellular organism which causes an ulcerating sexually transmitted infection, known as donovanosis or granuloma inguinale 1.
However, there is some debate about the classification of the causative organism. A link between C.
A more recent report has demonstrated a close similarity between C. Epidemiology Transmission of C. Rare transmission during delivery and occasional non-sexual transmission have been reported. Over the last twenty years the prevalence of donovanosis has decreased significantly and few cases are reported nowadays even in countries where the prevalence was once high.
Donovanosis has been associated with an increased risk of HIV infection. In Durban where HIV infection had been introduced only recently, the proportion of men with donovanosis and HIV infection increased significantly as the duration of lesions increased suggesting that HIV was acquired via sexual intercourse in the presence of ulcers Clinical Manifestations Donovanosis usually commences with ulceration in the ano-genital region.
Spread to local lymph nodes is followed by ulceration of skin overlying the lymph nodes. The ulcers are characterized by slow growth, absence of pain and friability. Hypertrophic lesions which stand out from the surrounding skin are common.
Primary oral lesions have been described. In women, lesions may involve the cervix and upper reproductive tract. Complications include tissue destruction, scarring, the development of genital lymphoedemahaematogenous dissemination to bones and viscera and squamous carcinoma.
Laboratory Diagnosis There are no established protocols for routine isolation and antibiotic susceptibility testing of C.
The diagnosis of donovanosis depends primarily on demonstrating the presence of intracellular organisms termed Donovan bodies in large mononuclear cells as Gram negative intracytoplasmic cysts filled with deeply staining bodies that may have a safety pin appearance Polymerase chain reaction PCR analysis using a colorimetric detection system can now be used in routine diagnostic laboratories and a genital ulcer multiplex PCR that includes C.
It has been suggested that the inability of C. A granulomatous inflammatory response is seen which leads to local tissue destruction and cutaneous ulceration.
Numerous unsuccessful attempts have been made to find an animal model for donovanosis. In DeMonbreun et al. It has not been possible so far to assess antibiotic activity against C.
The logical choice of therapy is thus an antibiotic with good activity against Gram negative bacteria, with good lipid solubility and capable of achieving a high intracellular to extracellular concentration ratio.
Relapse may occur if treatment is taken for too short a time. Donovanosis may in the future prove a suitable infection for treatment with liposome-encapsulated antibiotics.
Drug of Choice Table 2 summarizes data from the most important therapeutic trials.Study 65 Virology flashcards from Angelina T. on StudyBlue.
A patient presented with multiple cold sores in the mouth. Material from the mucocutaneous lesions was obtained by needle aspiration and directly inoculated to human embryonic fibroblasts (MRC-5 cells).
Donovanosis, a chronic cause of genital ulceration, has recently been the subject of renewed interest after a long period of relative obscurity.
The causative organism, Calymmatobacterium granulomatis, has been cultured for the first time in many years and a polymerase chain reaction diagnostic using a colorimetric detection system has been developed.
Calymmatobacterium granulomatis (donovanosis, granuloma inguinale), H. ducreyi (chancroid), H. influenzae (in respiratory, endocardial, and meningeal infections-concomitantly with .
Antigenic analysis of Chlamydia psittaci, C. trachomatis, and Lymphogranuloma venereum (LGV) Anogenital ulcers caused by Calymmatobacterium granulomatis as distinguished from lymphogranuloma inguinale (see LYMPHOGRANULOMA VENEREUM) caused by .
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Abell Administration Building East Chestnut Street Louisville, KY K. granulomatis was previously known as Calymmatobacterium granulomatis. K. trevisanii, initially named in , has been established as a heterotypic synonym for R. planticola and, therefore, is no longer recognized.