Operational Obstetrics & Gynecology

Granuloma Inguinale

This is a chronic, progressive, ulcerative, sexually-transmitted disease, involving the vulva, vagina or cervix.

The initial lesion is a papule which undergoes central necrosis to form a clean, granulomatous, sharply-defined ulcer. This process continues, with development of multiple, confluent ulcers, which may be painful or painless. The ulcers have a beefy red base which bleeds easily. Pseudobuboes in the groin can be felt.

The diagnosis is confirmed with biopsy of the ulcer, showing Donovan bodies on H&E stain or Giemsa stain.

This condition is rare in the United States, but somewhat more common in the tropical areas of southern Africa, India and New Guinea.

Treatment is

Trimethoprim-sulfamethoxazole one double-strength tablet orally twice a day for a minimum of 3 weeks, or

Doxycycline 100 mg orally twice a day for a minimum of 3 weeks, or

Ciprofloxacin 750 mg orally twice a day for a minimum of 3 weeks, or

Erythromycin base 500 mg orally four times a day for a minimum of 3 weeks.

Therapy should be continued until all lesions have healed completely.

Prognosis is excellent when treated in its early stages. Delayed treatment is associated with extensive scarring of the vulva, rectum and groin.

CDC Treatment Guidelines

Home ╖ Introduction ╖ Medical Support of Women in Field Environments ╖ The Prisoner of War Experience ╖ Routine Care ╖ Pap Smears ╖ Human Papilloma Virus ╖ Contraception ╖ Birth Control Pills ╖ Vulvar Disease ╖ Vaginal Discharge ╖ Abnormal Bleeding ╖ Menstrual Problems ╖ Abdominal Pain ╖ Urination Problems ╖ Menopause ╖ Breast Problems ╖ Sexual Assault ╖ Normal Pregnancy ╖ Abnormal Pregnancy ╖ Normal Labor and Delivery ╖ Problems During Labor and Delivery ╖ Care of the Newborn

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Operational Obstetrics & Gynecology - 2nd Edition
The Health Care of Women in Military Settings
CAPT Michael John Hughey, MC, USNR
NAVMEDPUB 6300-2C
January 1, 2000

This web version of Operational Obstetrics & Gynecology is provided by The Brookside Associates Medical Education Division. It contains original contents from the official US Navy NAVMEDPUB 6300-2C, but has been reformatted for web access and includes advertising and links that were not present in the original version. This web version has not been approved by the Department of the Navy or the Department of Defense. The presence of any advertising on these pages does not constitute an endorsement of that product or service by either the Department of Defense or the Brookside Associates. The Brookside Associates is a private organization, not affiliated with the United States Department of Defense. All material in this version is unclassified.

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