Donovanosis (Granuloma Inguinale) – Calymmatobacterium granulomatis
- Papua new Guinea (PNG); endemic aboriginal population northern Australia
- intracellular
- painless genital nodule or ulcer (occasional rectal tumour)
- secondary infection of ulcer
- phimosis, lymphoedema
- auto-inoculation, systemic spread – granulomatous lesions
- Dx: smear from scrapings
- Giemsa stain: bipolar rods in mononuclear cells
- Rx: tetracycline 1 month
- erythromycin if pregnant
- follow-up
Chancroid (Soft Chancre) – Haemophilus ducreyi
- South-East Asia → Australia
- inflamed macules → ulcers
- non-indurated, painful
- undermined edges
- purulent exudate
- perineal: penis, labia, clitoris, peri-anal
- inguinal lymphadenitis
- Dx: smear of ulcer base
- culture of scrapings (specialised medium)
- Rx: erythromycin
Lymphogranuloma Venereum – Chlamydia trachomatis (serotypes L1, L2, L3)
- Asia / Africa → Australia
- inguinal lymphadenopathy (buboes) and rectal strictures
- herpetiform vesicle / papule (ruptures) → small, painless punched-out ulcer which heals rapidly
- penis, vaginal wall, cervix
- secondary lesion: inguinal lymphadenopathy ± headaches, chills, sweats, weight loss, splenomegaly, polyarthritis
- Dx:
- Clinical: Primary lesion with lymphadenopathy
- Giemsa stain:
- Serology: 1/128 titres in CFTs or 1/512 in immunofluorescence
- Culture: bubo pus / genital lesion scraping
- Rx: tetracycline (+ aminoglycoside)
Donovanosis fact sheet – NSW Health
Lymphogranuloma venereum (LGV) – NSW Health