2018 UK national guideline for the management of donovanosis

O’Farrell, Nigel; Hoosen, Anwar A.; Kingston, Margaret

doi:10.1177/0956462418770319

Cited by 21 publications

(34 citation statements)

References 17 publications

(21 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Routine screening for other sexually transmitted infections and partner management are required. Patients should be followed up until lesions have healed completely (Fuchs and Brockmeyer 2014;O'Farrell and Moi 2016;O'Farrell et al 2018;CDC donovanosis, 2015). Zika Virus Infection (Dick et al 1952)…”

Section: Therapymentioning

confidence: 99%

Other Venereal Infections

Buder¹,

Lautenschlager²

2020

Braun-Falco´s Dermatology

View full text Add to dashboard Cite

Synonyms Lymphogranuloma inguinale; lymphopathia venerea; poradenitis inguinalis; Durand-Nicolas-Favre disease; climatic Bubo; LGV " Cave: lymphogranuloma inguinale should not be confused with granuloma inguinale (donovanosis). Epidemiology Lymphogranuloma venereum (LGV) is endemic in Asia, Africa, South America, and the southeastern USA. In Europe, LGV infection is found almost exclusively in MSM, clinically presenting as proctocolitis, and is commonly associated with HIV. In a prevalence study, serovars L1-3 were found in 1.7% of HIV-positive MSM and 0.6% of HIV-negative or untested MSM. The vast majority of these men were asymptomatic (Lanjouw 2016; de Vries et al. 2015; Haar 2013). Etiopathogenesis The pathogen is Chlamydia trachomatis (serovars L1-L3, mostly 2b), a coccoid, obligate intracellular bacterium (chapter "▶ Gonorrhea and Urethritis"). Although the serovars A-K remain in the mucosa, the L-serovars are invasive organisms that spread in blood, cerebrospinal fluid and spleen already in the early phase of the disease. Chlamydia trachomatis attaches to the host cells through the main outer membrane protein, the heat shock protein 70, and heparin-like glycosaminoglycans. Clinical Features The clinical picture is divided into three stages. Stage I: Primary Lesion The incubation period is 2-6 weeks. First, an inflammatory papule of a few millimeters in size appears. This rapidly transforms into a vesicle, then into a papulopustule and finally ulcerates. The primary lesion is clinically unspecific and short-lived and therefore often unnoticed. The manifestations can be seen on the glans penis, in the coronary sulcus, in the prepuce or anterior urethral segment of men and in the vulva, in the vagina, or in the cervix of women. The primary lesion is painless and is therefore often not noticed. It heals spontaneously within 10-14 days. In the current LGV epidemic in Europe and North America among MSM, the rectum is the most common site of infection. In this context, the patients suffer from anorectal syndrome with severe pain, bleeding, abdominal pain, diarrhea, or constipation. The clinical picture is indistinguishable from that of a chronic inflammatory bowel disease, such as Crohn's disease or ulcerative colitis, and therefore often fails to be noticed. Asymptomatic courses, which are of epidemiological importance for the spread of the disease, have been proven. " If proctitis is present, LGV infection should always be excluded. Stage II: Buboes A bubo is an inflammatory lymph node that can develop in the context of an STI, but also in other infectious, autoinflammatory or tumorous diseases (Fig. 1). About 24 weeks after the onset of the primary lesion the

show abstract

Section: Therapymentioning

confidence: 99%

Other Venereal Infections

Buder¹,

Lautenschlager²

2020

Braun-Falco´s Dermatology

View full text Add to dashboard Cite

show abstract

“…Antimicrobials commonly used to treat donovanosis have included doxycycline, co-trimoxazole and macrolides 3. Current guidelines for the management of donovanosis such as United States Centres for Disease Control, European and UK national guidelines recommend oral azithromycin in weekly or daily doses until complete ulcer healing 26–28. Oral erythromycin therapy was incorporated into the South African national GUD syndromic management algorithms between 1997 and 2015 29 30.…”

Section: Discussionmentioning

confidence: 99%

The changing epidemiology of genital ulcer disease in South Africa: has donovanosis been eliminated?

Müller¹,

Kularatne

2020

Sex Transm Infect

View full text Add to dashboard Cite

ObjectivesWe used an in-house molecular assay for the detection of Klebsiella granulomatis in ulcer specimens collected over a 12-year surveillance period in order to determine whether a diagnosis of donovanosis could be ascribed to genital ulcer disease (GUD) of unknown aetiology in our setting.MethodsBetween 2007 and 2018, a total of 974 genital ulcer specimens with no previously identified sexually transmitted (STI) pathogens were selected from STI aetiological surveys conducted in all nine provinces of South Africa. Giemsa-stained ulcer smears from the same participants had previously been routinely analysed for the presence of typical Donovan bodies within large mononuclear cells. A Klebsiella screening assay targeting the phoE (phosphate porin) gene was used in combination with restriction digest analysis and sequencing to confirm the presence of K. granulomatis.ResultsThe Klebsiella screening assay tested positive in 19/974 (2.0%) genital ulcer specimens. Restriction digest analysis and nucleotide sequencing of the phoE gene confirmed that none of these specimens was positive for K. granulomatis DNA. Similarly, Donovan bodies were not identified in the Giemsa stained ulcer smears of these specimens.ConclusionsThis is the first study to assess K. granulomatis as a cause of genital ulceration in South Africa over a 12-year surveillance period using molecular methods. The results demonstrate that K. granulomatis is no longer a prevalent cause of GUD in our population.

show abstract

“…As most cases of donovanosis presents clinically as a genital ulcer, the carrier has a 4.7 times increased risk of contracting HIV. 3 …”

Section: Epidemiologymentioning

confidence: 99%

“…As for its form of transmission, there is an interesting discussion in the literature if donovanosis is really an STI; there are two lines of thought regarding its transmission. The arguments that support the hypothesis of sexual transmission include: 3 , 21 , 25…”

Section: Epidemiologymentioning

confidence: 99%