Communicable Presentation (5) in health.pptx

Communicable

1. Granuloma Inguinale

2. Introduction Granuloma inguinale (donovanosis) is a genital ulcerative disease caused by the intracellular gram-negative bacterium Klebsiella granulomatis  (formerly known as  Calymmatobacterium granulomatis ). Granuloma inguinale is a sexually transmitted infection.

3. Introduction Granuloma inguinale is thought to be spread by sexual contact with an infected individual. Granuloma inguinale is communicable as long as the infected person remains untreated and bacteria from lesions are present.

4. What causes granuloma inguinale? Bacteria called Klebsiella granulomatis  causes granuloma inguinale. Anyone who has vaginal or anal sex with a partner with granuloma inguinale can pass on these bacteria.

5. Epidemiology Granuloma inguinale is extremely rare in high-resource countries but occurs in Papua New Guinea, Australia, southern Africa, the Caribbean, and parts of Brazil and India.

6. Symptoms of Granuloma Inguinale Symptoms of granuloma inguinale usually begin 1 to 12 weeks after infection. The first symptom is a painless, red nodule that slowly enlarges into a round, raised lump. Penis, scrotum, groin, and thighs in men Vulva, vagina, and surrounding skin in women Face Anus and buttocks in people who have anal intercourse

7. Symptoms of Granuloma Inguinale The sores slowly enlarge and spread to nearby tissue, causing further damage. Sores may also spread when they come into contact with other areas of the body. Sores heal slowly and may result in permanent scarring. Occasionally the infection spreads through the bloodstream to the bones, joints, or liver.

8. Differential Diagnosis The differential diagnosis for genital ulcers is broad and includes primary syphilis, secondary syphilis ( condylomata lata ), chancroid lymphogranuloma venereum, genital herpes neoplasm amoebiasis and several others.

9. Diagnosis of Granuloma Inguinale Examination of fluid from the sore Biopsy specimens are taken if the diagnosis is unclear or if adequate tissue fluid cannot be obtained because lesions are dry, sclerotic, or necrotic. To confirm the diagnosis of granuloma inguinale, doctors take a sample of fluid scraped from the sore and examine it under a microscope.

10. Diagnosis of Granuloma Inguinale Microscopic examination showing Donovan bodies in fluid from a lesion. Granuloma inguinale is suspected in people who live in areas where the infection is more common and who have sores typical of the infection.

11. Treatment of Granuloma Inguinale Antibiotics (various) Many oral antibiotics kill the bacteria, but tetracyclines, macrolides, and sulfamethoxazole are most effective, followed by  ceftriaxone, aminoglycosides fluoroquinolones  chloramphenicol.

12. Treatment of Granuloma Inguinale Follow-Up Patients should be followed clinically until signs and symptoms resolve.

13. Complications Possible complications include: Hematogenous spread Osteomyelitis Neoplastic changes Polyarthritis Pseudo-elephantiasis Stenosis of the urethra, vagina, or anus Vaginal bleeding

14. Prevention of Granuloma Inguinale The following general measures can help prevent granuloma inguinale (and other sexually transmitted infections): Safer sex practices, including  using a condom  every time for oral, anal, or genital sex Decreased risk of exposure to STIs by reducing the number of sex partners, not having high-risk sex partners (people with many sex partners or who do not practice safer sex).

15. Prevention of Granuloma Inguinale Prompt diagnosis and treatment of the infection (to prevent spread to other people) Identification of the sexual contacts of infected people, followed by counseling or treatment of these contacts