Granuloma inguinale typically causes a painless, red lump on or near the genitals, which slowly enlarges, then breaks down to form a sore.
Doctors suspect the infection if people have typical symptoms and live in areas where the infection occurs, and doctors confirm the diagnosis by examining a sample of fluid scraped from the sore.
Treatment with antibiotics is usually effective.
Using condoms during genital sex can help prevent passing granuloma inguinale and other sexually transmitted infections (STIs) from one person to another.
(See also Overview of Sexually Transmitted Infections Overview of Sexually Transmitted Infections (STIs) Sexually transmitted infection (STI) refers to an infection that is passed through blood, semen, vaginal fluids, or other body fluids during oral, anal, or genital sex with an infected partner... read more .)
Granuloma inguinale is extremely rare in high-resource countries but occurs in Papua New Guinea, Australia, southern Africa, the Caribbean, and parts of Brazil and India.
Symptoms of Granuloma Inguinale
Symptoms of granuloma inguinale usually begin 1 to 12 weeks after infection. The first symptom is a painless, red nodule that slowly enlarges into a round, raised lump. The lump then breaks down to form a foul-smelling sore near the site of the initial infection:
Penis, scrotum, groin, and thighs in men
Vulva, vagina, and surrounding skin in women
Anus and buttocks in people who have anal intercourse
The sores slowly enlarge and spread to nearby tissue, causing further damage. Sores may also spread when they come into contact with other areas of the body. Without treatment, the sores continue to spread.
Sores heal slowly and may result in permanent scarring.
Occasionally the infection spreads through the bloodstream to the bones, joints, or liver.
Diagnosis of Granuloma Inguinale
Examination of fluid from the sore
Granuloma inguinale is suspected in people who live in areas where the infection is more common and who have sores typical of the infection.
To confirm the diagnosis of granuloma inguinale, doctors take a sample of fluid scraped from the sore and examine it under a microscope.
If the diagnosis is unclear, doctors take a sample of tissue and examine it under a microscope (biopsy).
Treatment of Granuloma Inguinale
Testing and treatment of sex partners
Treatment is with the antibiotic azithromycin taken by mouth for at least 3 weeks.
The antibiotics trimethoprim-sulfamethoxazole, doxycycline, erythromycin, and ciprofloxacin are alternative treatments. Sometimes antibiotics are given by injection into a muscle or vein.
When treated, people usually begin to improve within 7 days. Healing may be slow and sores may recur. Then, treatment is required for a longer time. After treatment appears successful, people should be checked periodically for 6 months.
Current sex partners should be examined and, if infected, treated.
Prevention of Granuloma Inguinale
The following general measures can help prevent granuloma inguinale (and other sexually transmitted infections):
Safer sex practices, including using a condom Condoms Barrier contraceptives physically block the sperm’s access to a woman’s uterus. They include condoms, diaphragms, cervical caps, contraceptive gels, contraceptive sponges, and spermicides (foams... read more every time for oral, anal, or genital sex
Decreased risk of exposure to STIs by reducing the number of sex partners, not having high-risk sex partners (people with many sex partners or who do not practice safer sex), or practicing mutual monogamy or abstinence
Prompt diagnosis and treatment of the infection (to prevent spread to other people)
Identification of the sexual contacts of infected people, followed by counseling or treatment of these contacts