Diagnosis: Granuloma inguinale
Description: Two slowly growing painless ulcers
Morphology: Ulcer
Site: Penis
Sex: M
Age: 24
Type: Clinical
Submitted By: Ian McColl
Differential DiagnosisHistory: Granuloma inguinale is a chronic progressive ulcerating genital disease caused by Calymmatobacterium granulomatis,a gram negative bacillus.The micro organism was first identified by Donovan in 1905 and hence its other name of Donovanosis.The initial lesion is a small papule or nodule that subsequently ulcerates.The ulcers are vascular with a beefy red appearance and a tendency to bleed.The causative organisms are best found in smears rather than biopsies.They are seen in parasitised histiocytes similar to leishmaniasis.The recommended treatment is doxycycline and trimethoprim-sulfamethoxazole for at least 3 weeks.