Donovanosis - classification, symptoms and treatment, prevention. Donovanosis (granuloma venereal, granuloma inguinal)

Donovanose ( inguinal granuloma) is an infectious sexually transmitted disease. Characterized by slow flow, increased lymph nodes, the presence of ulcers in the genital area. It occurs in tropical countries with a hot climate, in Europe, Russia rarely get sick. Men get sick twice as often as women. The pathogen does not survive outside human body, and for its reproduction requires heat and moisture, so it is rare in cold and temperate climates.

Etiology

The causative agent is polymorphic bacteria - they can have different shape: in the form of a stick or a ball, sometimes they resemble an egg. Penetrate into the human body during sexual intercourse through cracks in the skin or mucous membranes. In tissues, they are taken up by macrophages. With the accumulation of more than 30 bacteria in the cell, the phagocyte dies, and the microorganisms are released.

There is a predisposition to the disease in patients with low level cellular immunity. Inguinal granuloma develops more often in people who have promiscuous sex, do not resort to hygiene products. The probability of getting sick during unprotected sex with a partner with donovanosis is 50%.

The disease develops at any age, but more often at 20-40 years old, does not depend on sexual orientation.

Methods of infection:

• during sexual contact - the most common;
• household - rarely;
• transplacental - upon contact of the child with the tissues of the mother affected by the granuloma.

Symptoms

Latent period - the time from infection to the first clinical manifestations- ranges from one week to three months. On the skin, mucous membranes, a slightly painful reddish nodule appears, which turns into an ulcer with torn edges, increasing in size. There is little exudate, with an unpleasant odor.

When the infection is transferred by hand, ulcers appear on the face, neck, mouth, and other parts of the body. Genital lesions are painful. With generalization of the infection, there may be diseases of the internal organs, sepsis.

This pathology in women or men, regardless of clinical manifestations, has several forms:

• with an ulcer;
• granulating;
• with necrosis;
• cicatricial;
• combined.

The ulcerative variety is the most characteristic: it occurs most often. ulcers Pink colour, with torn edges, a granular bottom, when palpated soft, slightly painful. Gradually, without treatment, they increase in size, capturing adjacent tissues.

The granulating variety is characterized by excessive growth of tissues protruding above the surface of the skin, with abundant discharge and putrid smell. Necrosis develops with the addition of purulent microflora. soft tissues destroyed to fascia and bones. Abundant purulent discharge, body temperature rises, chills, pain appear,. When the process is generalized, they are affected internal organs sepsis occurs. Possible death.

Scars are formed with a long illness. There are stenoses urethra, vagina, anus. With a combined variant of the disease, there are signs of different forms.

Treatment

Inguinal granuloma is a disease whose therapy should be complex.

Apply:

• broad-spectrum antibacterial drugs;
• immunomodulators;
• vitamin and mineral complexes.

Donovanosis treatment is carried out with the drug "Trimethoprim" - antibacterial agent wide spectrum of activity. Used to treat diseases of the urogenital area at a dose of 40-60 milligrams. Analogues of the drug - Biseptol, Bactrim, Bi-Septin.

The effectiveness of treatment increases when the drug is used together with the drug "Sulfamethoxazole". Combined drug"Co-trimoxazole" contains both components. Analogues "Intrim", "Duo-Septol", "Dvaseptol". Chronic forms require longer therapy.

In the absence of the effect of the drug, broad-spectrum antibiotics are used - "Ciprofloxacin", "Doxycycline". Treatment of donovanosis in pregnant women is with Erythromycin, as this medicine does not affect the fetus.

In addition to the main treatment, immunomodulators are used:

• "Interferon" - contained in the body, enhances natural immunity;
• "Imudon" - active against bacterial infections;
• "Amiksin" - a strong immune stimulant, has a number of contraindications;
• "Timogen" - enhances defensive forces organism.

Vitamin-mineral complexes are used as a general tonic treatment in order to provide the body necessary components for cellular metabolism, immune reactions.

Complications

With absence adequate therapy, the addition of secondary flora, appear inflammatory diseases: , phlegmon, necrosis of the genital organs. The long course of the disease leads to the formation of cicatricial stenosis of the vagina, urethra, anus. To eliminate such complications, it is necessary to surgery.

Donovanosis in both men and women is the cause of a rare but serious complication - elephantiasis of the external genital organs. This is a disease in which the outflow of lymph is disturbed, swelling of the scrotum, penis in men, and labia majora in women develop. Subsequent sclerosis, hyalinosis lead to irreversible changes in soft tissues.

Most severe complications- purulent fusion of the external genitalia in patients and development. Donovanosis in men can be the cause of self-amputation of the penis with its necrosis.

Donovanosis, the symptoms of which are on initial stages not expressed, do not disturb the patient, in advanced cases leads to grave consequences- Disability, deformity. Treatment of the disease, started in a timely manner, leads to a complete recovery. Prevention consists in preventing casual sexual relations (the presence of a permanent sexual partner), in maintaining a healthy lifestyle.

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Diseases with similar symptoms:

Inflammation of the lungs (officially pneumonia) is inflammatory process in one or both respiratory organs, which usually has an infectious nature and is caused by various viruses, bacteria and fungi. In ancient times, this disease was considered one of the most dangerous, and although modern facilities treatment allows you to quickly and without consequences get rid of the infection, the disease has not lost its relevance. According to official figures, in our country every year about a million people suffer from pneumonia in one form or another.

Jaundice - pathological process, the formation of which is influenced by a high concentration of bilirubin in the blood. The disease can be diagnosed in both adults and children. call like this pathological condition capable of any disease, and they are all completely different.

This disease has many names. But it is best known as donovanosis or venereal granuloma. latin word"granulum" is translated as a grain. Why is the disease called a grain? It's simple: small formations appear on the genitals, resembling a grain in shape.

Distribution and transmission routes

This disease is quite exotic for Russia. Compared to other STIs -, - infectious granuloma is rare. It is transmitted only sexually, and only adults are affected by it.

The causative agent of the disease is Calymmatobacterium granulomatis. It is a small bacterium shaped like an egg. It is also called Aragana-Vianna's stick or Donovan's body. As a result of sexual contact, the bacterium moves from the skin of a sick person to the skin of his partner.

The peculiarity of the microorganism is that it prefers a moist and warm environment. In temperate zones, the bacterium feels uncomfortable. It has received the greatest distribution in some regions of African countries, India, South America. Russian tourists who have sex with local residents epidemiologically dangerous states, they bring the infection home. The problem is that it is not always possible to protect yourself from infection with a condom.

Map of the worldwide distribution of donovanosis. Shaded countries are the likely permanent presence of the infection. Countries are also noted in which imported donovanosis is consistently detected.

But there is no need to panic. The presence of sexual contact with the carrier does not mean the inevitability of infection. Moreover, it is impossible to catch donovanosis in everyday life. A bacterium cannot live long outside the human body in our latitudes.

Many consider venereal granuloma a disease that does not deserve attention. Undoubtedly, there are heavier ones. However, this disease cannot be completely ignored. Like other sexually transmitted infections, donovanosis is dangerous, primarily due to complications. The disease does not go away spontaneously. If the venereal granuloma is not treated, it is fixed in the body, goes into chronic form which is very difficult to get rid of.

Signs of a venereal granuloma

From the moment of infection to the first symptoms of donovanosis, it can take three days, or maybe three months. It is easier for bacteria to enter the body through damaged skin. The disease is manifested by the appearance of inflamed papules. Then the formations are covered with red ulcers with a granular surface. The edges of the formation may be jagged or wavy. The papule itself is soft, but surrounded by hyperemic skin.

photo: ulcerative manifestation of donovanosis on the male genitalia

If the infection is secondary, then the ulceration becomes dirty-gray, covered with dead particles and crusts. Bloody pus, unpleasantly smelling, is released from them.

Favorite localization of sores is the genitals. However, the occurrence of papules near the anus, groin area and in other places is not excluded.

At the same time, the patient may feel well - the ulcers do not reveal themselves in any way (they are painless and do not itch).

Types of donovanose

Consider several forms of the disease: verrucous, ulcerative, necrotic, sclerosing, mixed, blooming, mucous.

• Most often, donovanosis manifests itself in ulcerative form. The sores that appear on the genitals are located in groups or singly. They are capable of spreading from the genitals to the groin. One of the manifestations of this type of venereal granuloma is keloid scars.
• At verrucous form, ulcers are observed, the bottom of which is strewn with bleeding warty growths. As a result of the appearance of scanty exudate, serous crusts with a bloody admixture are formed. The verrucous form is represented by two varieties: hypertrophic and elephantiasis. In the first case, a pink sore rises above the tissues adjacent to it. It is characterized by painlessness and slow growth.
• elephantiasis the form is characterized by a strong growth of the genitals (elephantiasis).
• blooming the form of donovanosis is manifested by ulcerations red with a velvety surface. Surrounding tissues are edematous and infiltrated. Pus flowing from ulcerative elements smells bad. The affected area is characterized.
• The most severe type of disease necrotic. Most often appears as a result of secondary infection. From the ulcers, a thickish content is released, which has dark brown color. The ulcer deepens into the muscle and bone tissue. The genitals are completely destroyed. The disease is complicated by lymphangitis and lymphadenitis. Patients may experience headache, chills, weakness, fever. Connection of secondary anemia is not excluded. After some time, the infection moves to the area of ​​the spleen, liver and other organs. Without timely treatment sepsis develops and death occurs.
• As a result of the appearance sclerosing types of infection is the narrowing of the external opening of the urinary duct, anus and the entrance to the vagina. The genitals are deformed.
• At mixed form, several types of donovanosis are simultaneously observed. The outcome depends on the prevailing form.

Diagnostics

Venereal or inguinal granuloma should be differentiated from and syphilis. To exclude syphilis, a serological sample is taken and people with whom the patient has had sexual contact are examined.

in the figure - STIs with ulcerative manifestations with which it is easy to confuse donovanosis

To exclude a soft chancre, the doctor conducts a microscopic examination of ulcerative exudate. If the causative agent of the disease is not found in it, an assumption is made about the presence of donovanosis.

To make a final diagnosis, the venereologist examines the patient, examines the discharge of the ulcer under a microscope. With insufficient information, a sowing technique is used: ulcerative exudate is applied to a special nutrient substrate. Bacteria (if present) actively multiply and become noticeable during the study. All examinations are carried out in stationary conditions.

Treatment of venereal granuloma

Some patients do not attach due importance to the treatment of donovanosis. For some reason, many people think that this is a harmless disease. Apparently misleading primary signs diseases: painless bumps on the skin.

But any disease, if left untreated, becomes chronic. For many years, the patient has been disturbed by ulcers that appear from time to time. If ignored, serious complications can arise.

The main principles of treatment of donovanosis include:

1. early therapy;
2. Contacting a specialist.

The fact is that venereal granuloma, like other STIs, is treated according to a strictly individual scheme. The choice of antibiotics depends on the development of pathology, the health of the patient and other factors.

Antibiotics are used to treat donovanosis. wide range actions and also sulfa drugs. With an uncomplicated form of the disease, the course of therapy is about four weeks. It is important to observe the terms of treatment, and not be limited to the disappearance of signs of venereal granuloma. To raise immunity, vitamin therapy and immunomodulatory agents are prescribed.

Therapeutic measures are completed if during the control examination of the patient the causative agents of donovanosis are not detected.

Forecast

The disease can be cured completely with timely diagnosis and adequate antibiotic therapy. Consequences of delayed treatment:

• Necrosis develops, due to which the destruction of the external genitalia occurs, and in some situations - the internal ones.
• There are cicatricial changes in the genitals, elephantiasis.
• There is a risk of squamous cell carcinoma at the site of ulcers.
• Secondary progressive anemia develops.

Prevention of venereal granuloma

Preventive measures can be divided into two groups:

1. The first group includes measures that are taken before infection occurs: explaining to people the dangers of casual sex, the need to use protective measures during sexual intercourse, compliance hygiene requirements. It's important to lead healthy lifestyle life to maintain immunity.
2. Activities of the second group are carried out after infection with Calymmatobacterium granulomatis has occurred, but the first symptoms have not appeared. People who have been to tropical regions and had unprotected sex recommended to be tested for STIs. If the causative agent of an infectious granuloma is detected, therapeutic measures are taken.

Video: doctor about donovanosis

Donovanosis (and also - inguinal granuloma, venereal granuloma, tropical ulcerative granuloma, fifth venereal disease, Broca's donovanosis) is a chronic, slowly progressive infectious sexually transmitted disease characterized by extensive skin ulcerations and lesions of the lymph nodes of the genital and perianal region.

Venereal granuloma only affects humans.

Donovanosis is an endemic tropical disease, especially widespread in New Guinea, among Indians in India, the Caribbean, Central and South Africa, in the southern provinces of China, in central Australia. In the US, granuloma venereum is rare, with most cases occurring in the southeastern states and predominantly in homosexuals. In Brazil, venereal granuloma ranks 5th among sexually transmitted diseases. In Europe, this disease is rare.

Occurrence of Donovanosis disease (groin granuloma)

The causative agent of venereal granuloma (Calymmatobacterium granulomatis) was discovered in 1905 in Madras by the Irish physician C. Donovan. Therefore, Calymmatobacterium granulomatis is sometimes referred to as Donovan's bodies.

Infection occurs mainly sexually, very rarely - household. Favorable to the spread of infection humid climate and heat environment. Disregard for the rules of personal hygiene and promiscuity matter. Assume also individual susceptibility to a venereal granuloma.

Symptoms of Donovanosis disease (groin granuloma)

Incubation period for donovanosis lasts from several days to 3 months or more. Donovan bodies penetrate through defects in the skin and mucous membranes, causing inflammatory response in the dermis or less commonly in the subcutaneous tissue. early manifestation diseases - acute inflammatory dermal papule with a flat surface, the size of a pea. In some cases, the initial lesion is represented by a vesicle-papule with a somewhat flattened surface, painless, small in size. Papules ulcerate, forming solitary ulcers with a velvety surface, painless, raised edges. The bottom of the ulcer is bright red in color, has a somewhat granular surface. As a rule, the genital organs (head of the penis, foreskin, clitoris, labia minora) perineum, anus, inguinal region, skin of the face, trunk, hands, lower legs, nasal mucosa, oral cavity, larynx, pharynx.

Typical donovanous ulcer It is a mass-producing granulation, resembles a tumor, has jagged or wavy edges, and is sharply demarcated from the surrounding skin. It is usually soft to the touch, but the surrounding skin may be edematous and thickened, juicy bright red, the bottom is clean, with a serous discharge. In secondary infection, the ulcer has a "dirty" appearance, covered with scabs and necrotic masses. Donovanous ulcers slowly grow along the periphery. Discharges from ulcers are scanty, serous-purulent, sometimes with an admixture of blood, have a characteristic fetid odor. The process proceeds relatively painlessly, adenopathy is insignificant, general state the patient is not disturbed. As a result of autoinoculation, or the transfer of infectious material by hand to areas of the skin, several additional ulcers may appear. The second place in frequency is occupied by donovanosis of the oral cavity. It is painful, teeth are involved in the process. With extragenital donavanosis, lips, gums, cheeks, palate, pharynx, larynx, nose, neck, and chest are affected. Systemic donovanosis affecting the bones, joints, liver, and spleen is rare.

Depending on the features clinical course and the predominance of one or another symptom of the disease, several clinical variants of donovanosis are distinguished: ulcerative, verrucous, blooming, necrotic, sclerosing, mucous, mixed.

Ulcerative form of donovanosis occurs most frequently. Ulcers in the genital area can be single or multiple and are characterized by a tendency to develop vegetations, serpiginous growth, spread into groin. Ulcerative forms diseases are divided into the following varieties: ulcerative-vegetative, serpiginous-ulcerative, ulcerative-penetrating, cicatricial-keloid.

A characteristic feature of the first two varieties is the tendency to develop vegetation or serpiginous growth and distribution in the area. inguinal folds. The ulcerative-penetrating form is more common in women who have extensive lesions, as a result of which estiomen can occur, as in late stage venereal lymphopathy. In the cicatricial-keloid variety, there is a tendency to form extensive keloid scars.

Verrucose form characterized by the appearance at the bottom of painless ulcers quite pronounced, pale pink, easily bleeding warty growths. The exudate released in a meager amount dries up with the formation of serous-bloody crusts that adhere tightly to the granulations. The ulcer is not painful, its course is torpid. Varieties of the verrucous form are 2 types: hypertrophic, elephantiasis.

In the hypertrophic type, the bottom of the ulcer is elevated above the surrounding skin and consists of large, rough, pale pink granulation tissue. The ulcer is painless, the discharge from it is scanty, it increases slowly. The elephantiasis type is characterized by a tendency to develop elephantiasis of the external genital organs.

Flowering form of Donovanose characterized by juicy, bright red granulations that have a velvety, moist surface. The bottom of the ulcer is sharply painful. The skin around the ulcer is swollen and infiltrated. The discharge from the ulcer is serous-purulent, has a specific bad smell. Patients complain of pain and intolerable itching in the affected area.

Necrotic Form is the most severe and usually develops in the chronic course of donovanosis. It occurs most often as a result of complications of pre-vanous ulcers. secondary infection. On the background chronic course suddenly there is an acute inflammatory process in which pink granulation tissue quickly replaced by a gray-brown necrotic with an abundance of thick discharge of chocolate color. The clinical picture of the necrotic form is characterized by the appearance of an increasing deep ulcer with purulent tissue breakdown. Lesions quickly spread along the periphery in depth, destroying tissues down to the fascia, muscles and bones. In women, the external genitalia, perineum and anus can be completely destroyed. In men, necrosis of the penis is possible up to its complete destruction. The process is accompanied by lymphangitis and lymphadenitis. Symptoms appear general malaise: weakness, headache, chills, fever. Acute secondary anemia may develop. As a result of further generalization of the process, infection can metastasize to the middle ear, liver, spleen, and bones. With untimely treatment, the development of sepsis with a fatal outcome is possible.

Sclerosing form of donovanosis causes narrowing of the external opening of the urethra, anus and the entrance to the vagina. The anatomical structure of the female genital organs is sharply disturbed, leading to their deformation.

Mixed form of donovanose characterized by the presence of symptoms of several varieties of the disease at the same time. Depending on the prevalence of certain symptoms, the prognosis for this form may be different.

Complications of donovanosis

As a rule, with timely started and competently carried out treatment of venereal granuloma (donovanosis), the prognosis for recovery is favorable, the disease is cured completely.

However, advanced venereal granuloma can lead to unpleasant complications and consequences, the most common of which are narrowing (stenosis) of the urethra in men, narrowing of the vagina in women, and narrowing of the anus in case of ulceration in the anus. These consequences occur during the healing of ulcers with the formation of a scar, hence their name - cicatricial stenoses. They often require surgery to remove them.

If the venereal granuloma continues to develop without treatment for many years, then its consequences can be even more severe. Among the complications of venereal granuloma, the most formidable are the destruction of the external and internal genital organs, the development of elephantiasis of the genital organs, and even malignant degeneration of ulcers ( squamous cell carcinoma).

It is quite easy to avoid this kind of complications - it is enough to contact a professional venereologist in time. Currently, venereal granuloma is easily, quickly and completely cured.

Forecast. With a timely diagnosis and the use of antibiotics, the prognosis of donovanosis can be considered favorable. In cases of late diagnosis and belated start of treatment, extensive necrosis may develop with subsequent destruction of not only the external, but sometimes internal genital organs, the development of disfiguring cicatricial changes (narrowing, stenosis of the anus, urethra, vagina), elephantiasis of the genital organs. Donovanous ulcers are prone to degeneration into squamous cell carcinoma. Sometimes, after suffering donovanosis, the development of secondary progressive anemia is possible.

Diagnosis of Donovanosis disease (inguinal granuloma)

The diagnosis is established after a complex of laboratory tests:

Ulcer-derived research serous fluid on the pale treponema in the dark field of a microscope;

Examination of smears discharged from ulcers (Gram-stained preparations) for Ducrey's streptobacilli;

Investigation of the causative agent of donovanosis in Leishman-stained or Romanovsky-Giemsa smears prepared by crushing pieces of tissue from the edges of ulcers between two glass slides. Even when a diagnosis of donovanosis is made, patients should be evaluated to rule out another concomitant venereal disease.

Treatment of Donovanosis disease (groin granuloma)

The main drugs for the treatment of donovanosis are antibiotics:

Sulfa drugs and antibiotics applied topically in the form of powders, lotions on ulcers after their preliminary cleansing with disinfectant solutions. According to indications, vitamins, biostimulants are prescribed. Some patients may need surgical intervention- elimination (excision) of elephantiasis, deforming, obliterating scars, vulvectomy, skin grafting. The need for such operations may also arise in patients with cured donovanosis, since the disease often ends in mutilation or deformity.

Prevention of Donovanosis disease (groin granuloma)

Preventive measures identical to those of other sexually transmitted diseases. Persons who have had sexual contact with patients with inguinal granuloma should be examined and treated if:

a) they had sexual intercourse within 60 days before the onset of symptoms in patients;

b) if they have symptoms and signs this disease.

Donovanosis is a chronic, slowly progressive disease belonging to the group of sexually transmitted diseases. It is also called Broca's donovanosis, tropical ulcerative granuloma, venereal granuloma. Otkrat in 1905 by the Irish physician Donovan. This is where the name came from. 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 in order to earn money, it does not lose its relevance.

The causative agent of this pathology is Calymmatobacterium granulomatis. When it is found in the material under study, given the length of the name, it is called Donovan's bodies. This immortalized the name of the discoverer once again. This microbe has the form of a stick surrounded by a capsule. It is resistant to acids. May exist in the form of cysts (when a protective sheath is formed). The route of transmission is sexual, but infections through 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 the rules of personal hygiene, defects (even micro defects) of the skin and mucous membranes.

The incubation period (hidden) lasts from 8 to 80 days. On average 17 - 50 days. At the site of the introduction of the pathogen, a papule appears - a formation the size of a pea. Reminds me of a Mantoux shot. Frequent localization in men: foreskin, glans penis, scrotum; in women: labia minora and their confluence.

A few days later, the papule ulcerates. Ulcers form, which slowly grow in size. Discharge from them is scanty, serous ( clear liquid), or serous-purulent with a characteristic unpleasant odor.

As mentioned above, donovanosis chronic illness. After a certain period of time, the skin heals or scars form and a period of imaginary well-being develops. The person feels healthy. Relapses can begin after 6 - 8 months, and sometimes after 2 - 4 years. Very often the infection is dirty hands and other areas of the skin. Despite the extensiveness of the process, the ulcers are painless, the nearby lymph nodes are not enlarged or slightly enlarged.

During oral contact, extra-sexual localization occurs - this is the oral cavity, when the lips, gums, cheeks, palate, larynx, nose, neck, and chest are affected. Teeth may also be involved in the process. Unlike the classic form, all this can be accompanied by soreness. During pregnancy, the symptoms will not differ. The difference is the choice of drugs and the management of childbirth in the future as pathological.

Donovanosis should almost always be differentiated from diseases such as syphilis, chancroid, skin tuberculosis, amoebiasis, squamous cell skin cancer. Accurate Diagnosis can only be delivered by passing tests, and for this you need to contact a venereologist.

Donovanosis treatment

The "gold" standard in diagnostics infectious process is the detection of the pathogen in the discharge of ulcers, which are taken with a curette or tweezers. It is also possible to inoculate the material on nutrient media, with the further growth of Donovan 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.

During pregnancy, it is advisable to prescribe benzylpenicillin or erythromycin. Fortifying preparations (vitamins).

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

During the treatment of ulcerative granuloma, it is necessary to strictly observe the rule of personal hygiene: daily change of underwear and bed linen, their boiling, ironing. Sexual intercourse and the use of alcohol in conjunction with antibiotics are excluded.

Given that donovanosis can occur as a chronic disease, a doctor's supervision for 2 years is necessary.

As you can see, the application folk remedies, especially the herbs growing in our latitudes, are not relevant.

Complications of donovanosis

The most unfavorable thing is that the symptoms of this disease, such as pain, malaise, are mild. Therefore, a lot of complications can occur. For example: tissue necrosis during prolonged current process(necrotic form). The process spreads along the periphery and in depth, destroying muscles and bones. All this can affect the liver, spleen. This phenomenon is facilitated by: post-abortion conditions, miscarriages, operations. With such a development of events, a fatal outcome is possible.

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

Violation of the integrity of the skin and mucous membranes with donovanosis is the entrance gate for other microbes, so their penetration into the skin and subcutaneous tissue with the advent erysipelas, abscesses. long-term consequences- This is a consequence of reduced local immunity and tissue degeneration, squamous cell skin cancer.

Prevention of donovanosis

The main method of preventing this disease is caution when staying in the above countries: avoiding casual sex, using condoms, personal hygiene.

Consultation of a dermatovenereologist on donovanosis

Q: How reliable is the use of chlorhexidine to prevent donovanosis?
Answer: Generally ineffective. In prevention, condoms and personal hygiene play the first role.

Q: When traveling tropical countries can i get the donovanose vaccine?
Answer: There is no such vaccine.

Question: Is it possible to get infected from exotic animals?
Answer: No. Donovanosis is transmitted only from person to person.

Dermatovenereologist Mansurov A.S.

Donovanosis - venereal infection, chronic nature, usually caused by a gram-negative microorganism, shaped like a short rod with rounded ends. This infection can be transmitted both sexually and non-sexually.

The incubation period of donovanose lasts from two days to several months. The infection affects the multilayered tissues of the epithelium. In this case, the general condition of the patient is usually not greatly disturbed. And only the necrotic form of donovanosis can lead to complications such as deformation in the structure of the genital organs.

The duration of the course of the disease is usually two to four years. There are forms of this disease of a fleeting nature - from two to four months, and there is an elongated form of donovanosis, it can drag on for several decades.

Symptoms

When the causative agent of donovanosis enters the human skin or mucous membrane, an inflammatory process begins to develop. Nodules small in diameter appear, which, with the course of the disease, increase to four to five centimeters.

Rarely, pustules or vesicles appear instead of nodules. The epithelium is covered with ulcers with raised wavy edges and a bright red bottom. When spreading the pathogen, ulcers can appear on the fingers, hands, lips, and oral mucosa.

With donovanosis, the following is observed clinical picture: all signs of general intoxication of the body appear - body temperature rises, chills, nausea appear, occasional vomiting. With this picture, the spread of the disease and the damage to the liver and spleen are possible, with further development sepsis.

Donovanosis without proper treatment leads to the development of such complications, which are manifested by: elephantiasis of the genital organs, narrowing of the urethra, anus and vagina, deformation of the genital organs.

Most often, these complications are observed in women, and this is explained by a different from the male anatomical structure genital organs and the entire genitourinary system.

Also, donovanosis can develop into a tumor of the surface epithelium (epithelioma).

Diagnostics

Diagnosis of donovanosis is based on the results laboratory tests at which the causative agent of the disease is detected.

Materials are taken from the ulcerous edges and smears are made for microscopic examination for donovanosis, they are stained according to the Romanovsky-Giemsa or Leishman method.

When diagnosing donovanosis, microscopic examination is considered mandatory, revealing pale treponema and Ducrey-Peterson streptobacillus. This study is differentiated in order to exclude a mixed type of infection.

Prevention

Prevention of donovanosis is a numerical decrease in sexual partners, the complete exclusion of sexual intercourse without contraceptive protection, personal hygiene, and timely detection and competent treatment infections.

Treatment

Treatment of donovanosis is carried out on an outpatient basis. The patient is prescribed antibiotics from the category of tetracyclines, erythromycins, gentomycins, lincomycins and ampicillins.

Sulfanilamide preparations - trimethoprim are also prescribed. If the patient begins to develop complications of donovanosis, surgical treatment is performed using surgical intervention.