Donovanoz( venereal granuloma) - Causes, symptoms and treatment. MF.

Donovanosis is a chronic, slowly progressing disease that belongs to the venereal group. He is also called Donovanosis Broca, tropical ulcer granuloma, venereal granuloma. Opened in 1905 by an Irish doctor Donovan. This is what caused the name. The disease is common in countries with a hot, humid climate: India, Burma, Central and South Africa, Vietnam. We have only "imported" cases, but given the development of the tourism industry, the departure of people for the purpose of earning, it does not lose relevance.

The causative agent of this pathology is Calymmatobacterium granulomatis. When it is found in the material under study, given probably the length of the name, they are called Donovan's calves. This also immortalized the name of the discoverer once again. This microbe has the form of a stick surrounded by a capsule. It is unstable to the action of acids. It can exist in the form of cysts( when a protective shell is formed).The way of transmission is sexual, but infections in household contacts are also described. It is believed that the condition for the spread of infection is a humid and warm climate, as well as non-compliance with personal hygiene rules, defects( even micro defects) of the skin and mucous membranes.

Calymmatobacterium granulomatis or Donovan body

Symptoms of donovanosis

The incubation period( latent) lasts from 8 to 80 days. In the middle and 17 - 50 days. At the site of the pathogen introduction, a papule appears - a formation the size of a pea. He remembers Mantoux vaccination. Frequent localization in men: foreskin, glans penis, scrotum, in women: small labia and the place of their fusion.

A few days later the papules ulcerate. Ulcers develop which slowly grow in size. Allocations from them are meager, serous( clear liquid), or serous - purulent with a characteristic unpleasant odor.

As already mentioned above, that preanovaz chronic disease. After a certain period of time, the skin heals or forms scars and a period of imaginary well-being develops. A person feels healthy. Relapses can begin in 6 - 8 months, and sometimes in 2 - 4 years. Very often an infection is entered with dirty hands and on other skin areas. Despite the vastness of the process, ulcers are painless, nearby lymph nodes are not enlarged or enlarged insignificantly.

When oral contacts occur, extra-localization occurs - it is the mouth cavity, when the lips, gums, cheeks, sky, larynx, nose, neck, and chest are affected. The process can involve teeth. In contrast to the classical form, all this can be accompanied by soreness. In pregnancy, the symptoms will not differ. The difference is the choice of drugs and the maintenance of further birth as pathological.

Donovanosis should almost always be differentiated from diseases such as syphilis, chancroid, skin tuberculosis, amoebiasis, squamous cell carcinoma of the skin. The exact diagnosis can be made only by the delivery of tests, and for this you need to turn to the venereologist.

Treatment of donovanosis

The "gold" standard in the diagnosis of the infectious process is the detection of the pathogen in the separated ulcers, which are taken with a curette or tweezers. It is also possible to sow material on nutrient media, with the further growth of Donovan's bodies. Also, with donovanosis it is necessary to be examined for all sexually transmitted diseases.

The main method of treatment, as well as other sexual infections, are antibiotics: levomethicin, gentamicin, unidox.

In pregnancy, it is advisable to prescribe benzylpenicillin or erythromycin. Stiffening preparations( vitamins).

Very important is the treatment of ulcers( cold lotions with further local application of hydrogen peroxide).The prognosis with a properly initiated and timely therapy is favorable.

During the treatment of ulcerative granuloma, the most important thing is to observe the rule of personal hygiene: the daily change of bed linen and bed linen, their boiling, ironing. Sexual intercourse and drinking are combined with taking antibiotics.

Given that donovanosis can proceed as a chronic disease, it is necessary to observe the doctor for 2 years.

As you understand, the use of folk remedies, especially grasses that grow in our latitudes, is not relevant.

Complications of the disease

The most unfavorable thing is that the symptoms of this disease, such as pain, malaise, are poorly expressed. Therefore, a lot of complications may occur. For example: necrosis of tissues during a long-term current process( necrotic form).The process spreads over the periphery and into the interior, destroying muscles and bones. All this can affect the liver, spleen. This phenomenon is promoted by: states after abortion, miscarriages, surgeries. Possible with this development of events and death.

Quite often, inflammation, and as a consequence of the violation of blood and lymph circulation leads to elephantiasis - an increase in the skin and subcutaneous tissue. This site( most often the genitals) acquire an ugly appearance with a violation of their function. As a result of the fact that connective tissue is formed in the place of ulcers, that is, scars, and, as a result: the narrowing of the vagina, phimosis( difficulty or inability to open the glans penis) and as a result of this difficulty in managing the sexual life.

Violation of the integrity of the skin and mucous membranes during donovanosis are the entrance gates for other microbes, so it is possible that they penetrate the skin and subcutaneous tissue with the appearance of erysipelas, abscesses. The remote consequence is a consequence of the lowered local immunity and degeneration of tissues, squamous cell carcinoma of the skin.

Prophylaxis of donovanosis

The main method of preventing this disease is caution when arriving in the countries listed above: avoidance of casual sex, condom use, personal hygiene.

Consultation of dermato-venereologist on donovanozu

Question: How reliable is the use of chlorhexidine for preventing donovanosis?
Answer: Generally ineffective. In the prevention of the first role are condoms and personal hygiene.

Question: When traveling to tropical countries, can I get vaccinated against donovanosis?
Answer: There is no such vaccination.

Question: Can I get infected from exotic animals?
Answer: No. Donovanosis is transmitted only from person to person.

Doctor dermatovenereologist Mansurov A.S.