zithromax and Granuloma-Inguinale

Donovanosis has been ignored for many years until recently. The condition still has a limited geographical distribution. A significant epidemic of donovanosis has been identified in KwaZulu/Natal, South Africa where it may be a risk factor for acquiring HIV in men. After a gap of more than 30 years, the organism was cultured by researchers in Durban, South Africa and Darwin, Australia. Polymerase chain reaction (PCR) techniques for donovanosis were developed soon after, most recently using a colorimetric detection system. Similarities between the causative organism, Calymmatobacterium granulomatis and Klebsiella spp. were confirmed. A proposal that the organism be reclassified under the genus Klebsiella has been put forward. Azithromycin has been confirmed as the drug of choice but is yet to be accepted universally because of cost issues. Treatment in patients with significant HIV induced immune deficiency may need to be prolonged. A donovanosis eradication programme is underway amongst the aboriginal community in Australia. Elsewhere, management through current syndromic guidelines for genital ulcers are yet to be validated in areas where donovanosis is endemic. PCR testing should enable further recognition of donovanosis and lead to more concerted efforts in disease control and possible eradication.

Topics: Anti-Bacterial Agents; Australia; Azithromycin; Calymmatobacterium; Communicable Disease Control; Female; Granuloma Inguinale; HIV Infections; Humans; Klebsiella; Male; Polymerase Chain Reaction; Risk Factors; South Africa

To determine the effectiveness of azithromycin, an azalide antibiotic with long tissue half-life, in a pilot study of patients with genital donovanosis in the Northern Territory, Australia.. Patients with histologically confirmed donovanosis were randomised to receive one of two open-label azithromycin dosage regimens: Regimen A--1.0 g once weekly for 4 weeks; or Regimen B--500 mg daily for 7 days. Patients were assessed at 6 weeks and classified as either "cured", "improved" or "failed".. Seven patients received regimen A and 4 received regimen B. Six weeks after commencing treatment the genital ulcers of four patients receiving regimen A and one patient receiving regimen B had healed; the lesions of the other six patients (3 in each regimen) were "improved". No patient failed to respond and no significant adverse reaction was recognised. The eleven patients were reviewed after completing the six-week trial; all lesions had re-epithelialised without further antibiotic treatment, no relapses had occurred, the longest follow-up period being seven months. A further 17 patients with donovanosis who were unable to meet the entry criteria were also treated successfully with azithromycin during the study period.. This is the first time that azithromycin has been shown to have clinical activity against donovanosis. Poor compliance with prolonged courses of antibiotics is one of the major barriers to control of the disease. Intermittent or short-course therapy, made possible by the long tissue half-life of the drug, could facilitate control of donovanosis in endemic populations if the high cost of medication can be addressed.

Topics: Adolescent; Adult; Anti-Bacterial Agents; Azithromycin; Drug Administration Schedule; Female; Granuloma Inguinale; Humans; Male; Middle Aged; Pilot Projects

Topics: Adult; Anti-Bacterial Agents; Azithromycin; Female; Granuloma Inguinale; Humans; Male; Middle Aged; Native Hawaiian or Other Pacific Islander; Pilot Projects; Racial Groups; Wound Healing

Topics: Anti-Bacterial Agents; Azithromycin; Chlamydia trachomatis; Ciprofloxacin; Erythromycin; Granuloma Inguinale; Humans; Ofloxacin

Topics: Azithromycin; Female; Granuloma Inguinale; Humans; Infant; Infectious Disease Transmission, Vertical; Lymphadenitis; Mastoiditis; Meningitis

Donovanosis is a rare sexually transmitted infection now mainly seen in sporadic cases in Papua New Guinea, South Africa, India, Brazil and Australia. The causative organism is Calymmatobacterium granulomatis though a proposal has been put forward that the organism be reclassified as Klebsiella granulomatis comb. nov. The incubation period is approximately 50 days with genital papules developing into ulcers that increase in size. Four types of lesions are described - ulcerogranulomatous, hypertrophic, necrotic and sclerotic. The diagnosis is usually confirmed by microscopic identification of characteristic Donovan bodies on stained tissue smears. More recently, polymerase chain reaction (PCR) methods have been developed. The recommended treatment is azithromycin 1 g weekly until complete healing is achieved.

Topics: Anti-Bacterial Agents; Azithromycin; Calymmatobacterium; Europe; Granuloma Inguinale; Histocytochemistry; Microscopy; Polymerase Chain Reaction

A 29-year-old female presented with chronic postpartum abdominal pain. Computerized tomography scan was consistent with ovarian carcinoma, and biopsy yielded macrophages laden with eosinophilic bodies. Cultures, histoplasma serologies, and taxoplasma serologies were negative. A diagnosis of pelvic donovanosis was reached; the patient was treated with azithromycin resulting in clinical and radiographic resolution.

Topics: Abdominal Pain; Adult; Anti-Bacterial Agents; Azithromycin; Diagnosis, Differential; Female; Granuloma Inguinale; Humans; Ovarian Diseases; Ovarian Neoplasms; Puerperal Infection; Tomography, X-Ray Computed

We report on a patient from a London clinic, (a Jamaican heterosexual man known to have herpes) who has donovanosis and syphilis in a single genital ulcer. The case highlights the importance of careful clinical examination of genital ulcers.

Topics: Azithromycin; Doxycycline; Granuloma Inguinale; Herpes Simplex; Humans; Male; Middle Aged; Penile Diseases; Syphilis

Azithromycine is recommended in the treatment of donovanosis with a 7-day treatment cycle. We report the efficacy of a single cure of 1 gram in two patients.. Four patients, presenting with donovanosis, were treated with azithromycine according to 2 regimens. The first used 500 mg/d the molecule during 1 week, the second used azithromycine in single cure of 1 gram. The latter led to the complete cure of 2 patients.. Many antibiotics are used in the treatment of donovanosis. Since 1996, Australian authors have used azithromycine in this indication. A single dose of this molecule appears effective in recent and confined donovanosis.

Topics: Adult; Aged; Anti-Bacterial Agents; Azithromycin; Granuloma Inguinale; Humans; Male

We present a case of a 39-year-old woman with a vulval lesion, which macroscopically looked consistent with a fungating squamous cell carcinoma of the vulva. However, further investigations demonstrated a less common cause for this presentation.

Topics: Adult; Azithromycin; Carcinoma, Squamous Cell; Diagnosis, Differential; Female; Granuloma Inguinale; Humans; Penicillin G Benzathine; Syphilis; Vulvar Diseases

Topics: Anti-Bacterial Agents; Azithromycin; Calymmatobacterium; Granuloma Inguinale; Humans; Infant; Infectious Disease Transmission, Vertical; Lymphatic Diseases; Male; Neck

Topics: Azithromycin; Granuloma Inguinale; Humans

Topics: Anti-Bacterial Agents; Azithromycin; Ciprofloxacin; Contraindications; Doxycycline; Female; Genital Diseases, Female; Genital Diseases, Male; Gentamicins; Granuloma Inguinale; Humans; Infectious Disease Transmission, Vertical; Male; Pregnancy; Pregnancy Complications, Infectious; Ulcer

Topics: Anti-Bacterial Agents; Azithromycin; Granuloma Inguinale; Humans

Topics: Anti-Bacterial Agents; Azithromycin; Granuloma Inguinale; Humans

Topics: Adult; Anti-Bacterial Agents; Azithromycin; Granuloma Inguinale; Humans; Penicillin G Benzathine; Syphilis

Topics: Adult; Azithromycin; Female; Granuloma Inguinale; Humans; Male; Syphilis; Urethritis