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Therapeutic Approach

Granuloma inguinale, also known as donovanosis, is an uncommon sexually transmitted infection (STI) of the skin that manifests as painless but slowly expanding “beefy” red genital ulcers without inguinal lymphadenopathy.1 The causative organism is the bacterium Klebsiella granulomatis, an intracellular gram-negative rod. Administration of systemic antibiotics, typically by oral route, is the mainstay of treatment. Guidelines from the Centers for Disease Control and Prevention (CDC) recommend a minimum treatment duration of 3 weeks and until all lesions are healed. It is prudent to screen patients for other STIs, including syphilis and HIV. Contact tracing of known sexual partners and reporting of cases to local and national health agencies should be considered, if applicable. See Table 146-1.

Table 146-1Granuloma Inguinale Treatment Table

Levels of evidence are based on the Journal of the American Academy of Dermatology guidelines: level IA evidence includes evidence from meta-analysis of randomized controlled trials; level IB evidence includes evidence from ≥1 randomized controlled trial; level IIA evidence includes evidence from ≥1 controlled study without randomization; level IIB evidence includes ...

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