- Donovanosis
Taxobox | name = "Calymmatobacterium granulomatis"
regnum =Bacteria
phylum =Proteobacteria
classis =Gamma Proteobacteria
ordo = Enterobacteriales
familia =Enterobacteriaceae
genus =Calymmatobacterium orKlebsiella
species =granulomatis Donovanosis, also known as granuloma inguinale, is a
bacteria ldisease that has reached endemic proportions in many underdeveloped regions. Because of the scarcity of medical treatment, the disease often goes untreated. The disease is characterized by painless genital ulcers which can be mistaken forsyphilis . [Murray P. et al. (2005), "Medical Microbiology, fifth ed.", Elsevier Mosby, p. 336.] However, they ultimately progress to destruction of internal and external tissue, with leakage ofmucus andblood . The destructive nature of donovanosis also increases the risk ofsuperinfection by other pathogenic microbes.Classification
The proper clinical designation for donovanosis is "
granuloma inguinale ". [Murray P. et al. (2005), "Medical Microbiology, fifth ed.", Elsevier Mosby, p. 336.]Granuloma is a nodular type of inflammatory reaction, and inguinale refers to theinguinal region, which is commonly involved in this infection. The disease is commonly known as "donovanosis", after the Donovan Bodies which are a diagnostic sign. Discovered by a researcher named Donovan, theseintracellular inclusions represent bacteria that have been engulfed by scavenger cells calledmononuclear phagocytes orhistiocytes .The causative organism, "
Klebsiella granulomatis", used to be called "Calymmatobacterium granulomatis" (some source still use this classification) [DorlandsDict|four/000046076|granuloma inguinale] , from the Greek "kalymma" (a hood or veil), referring to the lesions that contain the bacteria. Prior to this it was called "Donovania granulomatis", named after the Donovan Bodies. [Murray P. et al. (2005), "Medical Microbiology, fifth ed.", Elsevier Mosby, p. 336.] The species name "granulomatis" refers to the granulomatous lesions. The organism was recently reclassified under the genus "Klebsiella", a drastic taxonomic change, since it involved changing the organism'sphylum . However,polymerase chain reaction (PCR) techniques using a colorimetric detection system showed a 99% similarity with other species in the "Klebsiella" genus.Fact|date=April 2008ymptoms
Small, painless nodules appear after about 10–40 days of the contact with the bacteria. Later the nodules burst, creating open, fleshy, oozing lesions. The infection spreads, mutilating the infected tissue. The infection will continue to destroy the tissue until treated. The lesions occur at the region of contact typically found on the shaft of the
penis , the labia, or the perianal region. Rarely, thevagina l wall orcervix is the site of the lesion.Transmission
The microorganism spreads from one host to another through contact with the open sores. Oral, vaginal or anal intercourse are high risk behaviors to engage in with someone who is infected.
Diagnosis
The patient’s sexual history is requested. Experienced doctors are able to diagnose donovanosis by only looking at the ulcers. However, it may be necessary for the health care provider to take a sample of tissue in order to correctly diagnose the disease. He or she may decide to add a
Wright-Giemsa stain in order to better view the cells. Additionally, the presence of Donovan bodies in the tissue sample confirms donovanosis.Treatment
Three weeks of treatment with
erythromycin ,streptomycin , ortetracycline , or 12 weeks of treatment withampicillin are standard forms of therapy. Normally, the infection will begin to subside within a week of treatment, however, the full treatment period must be followed in order to minimize the possibility of relapse.Prevention
The disease is effectively treated with
antibiotics , therefore, developed countries, like theUnited States , have a very low incidence of donovanosis, (approximately 100 cases reported each year in the United States.) However, sexual contacts with individuals in endemic regions dramatically increases the risk of contracting the disease. Avoidance of these sexual contacts, and STD testing before beginning a sexual relationship are effective preventative measures for donovanosis.References
Further reading
*cite journal |last=Boyea |first=Kit |authorlink= |coauthors=Hansen, Dennis S. |year=2003 |month= |title=Sequencing of 16S rDNA of "Klebsiella": taxonomic relations within the genus and to other "Enterobacteriaceae" |journal=International Journal of Medical Microbiology |volume=292 |issue=7–8 |pages=495–503 |doi=10.1078/1438-4221-00228 |url= |accessdate= |quote=
*cite journal |last=Carter |first=Jenny S. |authorlink= |coauthors="et al." |year=1999 |month= |title=Phylogenetic evidence for reclassification of "Calymmatobacterium granulomatis" as "Klebsiella granulomatis" comb. nov. |journal=International Journal of Systematic Bacteriology |volume=49 |issue=4 |pages=1695–1700 |doi=10.1099/00207713-49-4-1695 |url= |accessdate= |quote=
*cite journal |last=O’Farrell |first=N. |authorlink= |coauthors= |year=2002 |month= |title=Donovanosis |journal=Sexually Transmitted Infections |volume=78 |issue=6 |pages=452–457 |doi=10.1136/sti.78.6.452 |url= |accessdate= |quote=
*Gavin Hart MD, MPH Transcript of the lecture given at the Australian Society for Infectious Diseases/Australasian College of Tropical Medicine Conference at Palm Cove (Cairns), Queensland on19 April 1999 .
*2001 National Guideline for the management of Donovanosis (granuloma inguinale) Association for Genitourinary Medicine and the Medical Society for the study of Venereal DiseasesExternal links
* [http://www.nlm.nih.gov/medlineplus/ency/article/000636.htm Medline Plus description of Donovanosis (Granuloma inguinale)]
* [http://www.emedicine.com/derm/topic172.htm eMedicine description]
* [http://ijs.sgmjournals.org/cgi/content/abstract/49/4/1695 Research supporting Klebsiella Genus classification]
* http://www.epigee.org/health/granu_ingui.html
* http://www.nlm.nih.gov/medlineplus/ency/article/000636.htm
* http://www.healthatoz.com/healthatoz/Atoz/ency/granuloma_inguinale.jsp
* http://www.indepthlearning.org/std/STDnew.php/76C.html
* http://www.stdservices.on.net/publications/pdf/donovanosis.pdf
* http://www.fasthealth.com/dictionary/c/Calymmatobacterium.php
* [http://www.mercksource.com/pp/us/cns/cns_hl_adam.jspzQzpgzEzzSzppdocszSzuszSzcnszSzcontentzSzadamzSzencyzSzarticlezSz000636zPzhtm Resource Library:Granuloma inguinale]
* http://www.bacterio.cict.fr/e/enterobacteriaceae.html
* http://www.mansfield.ohio-state.edu/~sabedon/biol3018.htm
* http://www.dscc.edu/bwilliams/Biology/Monera.htm
* http://www.sidwell.edu/us/science/vlb5/Labs/Classification_Lab/classification_lab.html
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