Granuloma Inguinale or donovanosis is a sexually transmitted disease caused by chronic bacterial infection, is progressive, and destructive that attacks the skin in the genital area and surrounding areas in the form of ulcers or sores. Although this disease is mainly transmitted through intimate contact, but this disease can be transmitted if healthy people are exposed to fluid wounds of sufferers.
Symptoms of Inguinale Granuloma
The development of this disease is slow, usually around 17 days after the bacteria enter the body to cause symptoms and it takes up to 12 weeks for a real skin injury. There are no symptoms of fever in this disease.
Skin lesions develop through 3 stages, namely:
- The first stage, the genital skin or around the anus will look small red bumps like pimples then the color changes to pink or faded red. These lumps will enlarge to form fine red nodules. These lumps do not hurt, but these lumps bleed easily.
- The second stage, the bacteria begins to damage the skin which is seen from a lump turned into a superficial wound (ulcer) spread from the genitals and anus to the lower thigh. Then develop into a large dry wound, much like genital warts. The wound is foul smelling.
- The third stage, the infection continues and the damage occurs even worse so that the large wound becomes deeper and causes scarring.
If left unchecked and the infection continues there will be complications from Granuloma Inguinale, including:
- Infection can spread to the lymph nodes in the groin causing a lump in the groin and cause scarring in the lymph nodes, causing permanent swelling.
- Infection can also spread through the blood, then bacteria can infect other body organs such as bones, joints, lungs, and liver.
Causes of Inguinale Granuloma
This disease is caused by Klebsiella granulomatic bacteria that live in cells. The mode of transmission mainly occurs through sexual contact, but it is suspected that this bacterium has a low infectious ability so it requires repeated exposure for the occurrence of this disease.
In addition, this disease can be transmitted through the anus in people who have anal sex or through the normal birth canal to an infected mother to her baby.
Risk Factors for Inguinale Granuloma
Some risk factors that can increase a person affected by this infection, follow
- Having unsafe intimate relationships, such as not using a condom, have multiple sex partners.
- Homosexuals, engaging in male-to-male sex have a higher risk of developing this disease compared to heterosexuals.
Diagnosis of Inguinale Granuloma
Granuloma Inguinale is difficult to detect at an early stage. New Granuloma Inguinale is suspected if an injury (ulcer) arises. Laboratory tests are carried out to help establish the diagnosis by means of a swab , which is taking fluid samples from the wound (ulcer) with a cotton bud .
After that, the cotton bud is smeared on a glass preparation and examined under a microscope to find bacteria. Biopsy is done if the wound does not heal or bacteria are not found after the swab examination .
Prevention of Inguinale Granuloma
Granuloma Inguinale is a disease that is transmitted through intimate relationships, therefore having safe sex is a preventive measure that can be done, such as the use of condoms, not changing sexual partners, not having sex with commercial sex workers.
Treatment of Inguinale Granuloma
Early treatment of Granuloma Inguinale aims to kill the causative bacteria and prevent compilation such as scarring and permanent swelling in the genital area, anus and groin. Treatment of this disease uses antibiotics. According to the Center for Disease Control and Prevention (CDC ) the first recommended antibiotic for this disease is Azithromycin . Other alternative antibiotics can be given doxycycline , ciprofloxacin, erythromycin, and cotrimoxazole.
The duration of treatment with antibiotics is at least 3 weeks and continued until the wound heals completely and all symptoms disappear. Recurrence of this disease can occur within 6-18 months after antibiotic therapy and repeat antibiotic therapy is needed with antibiotics that are stronger than before. We recommend that you discuss with your doctor before using the antibiotics mentioned above, so that the diagnosis is correct and the use of antibiotics is also right.
If scar tissue has formed and permanent swelling of the genitals, anus and groin, after the infection has healed, surgical therapy can be done to correct the condition.
