Penis & scrotum


Granuloma inguinale

Last author update: 1 February 2010
Last staff update: 30 August 2022

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PubMed Search: Granuloma inguinale penis

Alcides Chaux, M.D.
Antonio L. Cubilla, M.D.
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Cite this page: Chaux A, Cubilla AL. Granuloma inguinale. website. Accessed September 21st, 2023.
Definition / general
  • Initially described in India by McLeod (1882) and Donovan (1905)
  • Sexually transmitted disease caused by Klebsiella granulomatis, formerly Calymmatobacterium granulomatis, a gram negative rod
  • Initially a small painful nodule at infection site that ulcerates; may have satellite lesions
  • Also called donovanosis
  • Rare in U.S. (100 cases/year)
  • More common in African Americans, in individuals with a lower socioeconomic status and among those untrained in hygiene
  • Endemic in tropical and subtropical climates such as Papua New Guinea, parts of South Africa, parts of India, Indonesia and Australian aborigines (Braz J Infect Dis 2008;12:521)
  • Can affect foreskin, glans, penile shaft or scrotum
Case reports
  • Three weeks of treatment with erythromycin, streptomycin or tetracycline or 12 weeks of treatment with ampicillin
  • Usually clinical improvement within 1 week
Clinical images

AFIP images
Figure 10-76 Figure 10-76

Figure 10-76

Scrotum and inner thigh skin

Scrotum and inner thigh skin

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Ulcerated lesion with hypertrophic borders

Various images

Beefy red penile ulcer

Multiple ulcers on the penile shaft, pubis and scrotum

Raw granulation tissue

Diffuse ulceration

Microscopic (histologic) description
  • Massive plasma cell infiltrate without lymphocytes in granulation tissue
  • Diffuse infiltration by neutrophils forming microabscesses
  • Large mononuclear cells (also called Pund cells) with Donovan bodies (large intracytoplasmic encapsulated bipolar bodies, highlighted with Warthin-Starry or Wright-Giemsa stain)
Microscopic (histologic) images

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Donovan bodies

Squamous cells and keratin pearls

Positive stains
Electron microscopy description
  • Bacteria residing inside phagosomes of macrophages
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