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Pathology for Urologists

Granuloma Inguinale (Donovanosis)


Image A
(click on the image above)

Image B
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  • Agent: Calymmatobacterium granulomatis (human itch mite)
  • Appearance: Gram-negative pleomorphic intracellular bacilli
  • Clinical: single or multiple small papules that coalesce to form ulcers which are non-tender, indurated, firm, and have abundant beefy-red granulation tissue at the base (image A).
  • Transmission: only mildly contagious.
  • Histology:
    • Ulcers contain abundant granulation tissue with numerous large histiocytes containing the dark particulate inclusions (Donovan bodies) that are best seen on silver stain (image B).
    • Diagnosis must be established by microscopy because the bacilli are not readily cultured
  • Treatment: antibiotics are usually curative, although relapse may occur if the antibiotics are discontinued too early

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