Granulomas inguinaleor donovanosis is a sexually transmitted infection caused by bybacteria Klebsiella granulomatis. This disease usually occurs in people aged between 20-40 years who are sexually active.
Inguinal granulomas can be characterized by the appearance of small, painless red bumps in the genital area. These lumps slowly enlarge, then rupture and form sores. If left untreated, these wounds can become permanent scars.
Granuloma inguinale is a type of sexually transmitted infection that is quite rare. This condition usually occurs in someone aged 20-40 years who are sexually active. This disease is more common in men than women.
Causes of Inguinal Granuloma
Inguinal granulomas are caused by bacteria Klebsiella granulomatis. A person can be infected by this bacterium through vaginal (through the vagina) and anal (through the anus) sex. In rare cases, these bacteria can also be transmitted through oral sex (by mouth).
Given that granuloma inguinale is transmitted through sexual contact, the risk of developing this disease is higher in people who are sexually active, especially people aged 20-40 years.
Inguinal granulomas are also known to be more common in men than women. Therefore, people with MSM behavior (male sex) are more susceptible to contracting granuloma inguinale than heterosexual people.
In addition to the factors mentioned above, inguinal granulomas are also more common in tropical and subtropical regions.
SymptomInguinal Granulomas
Symptoms of inguinal granuloma appear and develop slowly. Usually, the time between the onset of infection and the appearance of symptoms is 1–12 weeks.
The initial symptom of an inguinal granuloma is a red bump that appears in the groin area. These lumps are small and painless, so the sufferer often goes unnoticed. In patients who have anal or oral sex, lumps also appear in the anus or face area.
Symptoms of inguinal granuloma develop in three stages, namely:
The first stage
At this stage, the lump will spread to the area outside the groin. The lump will enlarge with a soft surface when touched. Although not painful, these lumps bleed easily when rubbed.
Second stage
In the second stage, bacteria start to damage the skin, thus forming an open sore in the groin that causes an unpleasant odor. In male patients, these open sores may appear on the penis, scrotum, and groin. Whereas in female patients, sores can form on the vulva, vagina, and the surrounding area.
Third phase
In the third stage, the wound that forms deepens and forms scar tissue around the groin.
Inguinal granuloma infection can also spread to the lymph nodes in the groin and cause the area to swell. In addition, the infection can also spread to the bones, joints, and liver, through the bloodstream.
When to go to the doctor
Immediately consult a dermatologist and genital specialist if the above symptoms and signs appear. Examination should also be done immediately if your sexual partner is known to have inguinal granuloma.
Check with your doctor for sexually transmitted infections regularly if you are sexually active, change partners frequently, or have sex without using a condom.
DiagnosisInguinal Granulomas
The symptoms of inguinal granuloma are similar to those of lymphogranuloma vereneum (LGV), chancroid, syphilis, penile cancer, and vulvar cancer. Therefore, this disease is difficult to diagnose.
Usually, patients are suspected of having this disease after an open wound in the groin area appears, especially if the wound does not heal. However, to be sure, the doctor will take a tissue sample (biopsy) from the patient's wound to detect the presence of bacteria Klebsiella granulomatis.
TreatmentInguinal Granulomas
Treatment of inguinal granulomas should be done early to prevent swelling and permanent scar tissue formation around the genitals. The method of treatment is to give antibiotics in the form of a drink or injection for 3 weeks. Types of antibiotics given include:
- Trimethoprim-sulfamethoxazole
- Ciprofloxacin
- Doxycycline
- Erythromycin
- Azithromycin
- Gentamicin
Patients generally improve within 7 days of treatment. But if the infection has spread to the lymph nodes in the groin, the healing process may take longer. In addition, lumps can grow back, so the patient is obliged to take treatment until declared cured by the doctor.
During the healing process, the patient should not have sexual intercourse. Patients are also required to regularly check with the doctor for up to 6 months after recovering.
In addition to patients, examination and treatment were also carried out on partners of patients with granuloma inguinale who experienced similar symptoms.
ComplicationsInguinal Granulomas
Complications that can arise from granuloma inguinale disease or donovanosis include:
- Fading skin color in the groin area
- Damage or permanent scarring of the genitals
- Permanent swelling of the genitals due to scar tissue
- Recurrent inguinal granuloma infection
Inguinal Granuloma Prevention
As described above, inguinal granuloma is transmitted through sexual contact. Therefore, the main way to prevent this disease is to have safe sex, namely by wearing condoms and not changing sexual partners.