Granuloma Inguinale

Wounded

Step 1: View clinicals

A 42 year old man presents with several painless penile ulcers for 2 months. These initially manifested as painless nodules, which then evolved into ulcers over the course of a month. Immediately prior to this, he had traveled to South Africa, where he engaged in several unprotected sexual encounters. His medical and surgical histories are otherwise unremarkable.


Step 2: Order all relevant investigations

Dark field Microscopy

No organisms are seen.

Biopsy Ulcers

Multiple Donovan bodies are seen.

Cultures for H. ducreyi

No growth is noted.

VDRL

The VDRL test is negative.


Step 3: Select appropriate management

Doxycyclin
Screen Partner
Penicillin
Sodium Stibogluconate


Score: ★★☆