1. What are the causes of inguinal granuloma? Inguinal granuloma, donovanosis, is caused by a bacterium called Klebsiella granulomatis. The disease occurs in tropical and subtropical regions such as the East Indies and New Guinea. It is sometimes transmitted by travel between continents and thus often affects people in European countries and America. On average, in Europe and America there are 100 new registered cases each year of the transmissible disease. The disease spreads most often during vaginal and anal sex. Very rarely it can be caused by oral sex. Men are more susceptible to the disease than women. It occurs most often between the ages of 20 and 40. It is less common in children and people over the upper age limit. 2. Symptoms Symptoms can appear from 1 to 12 weeks after contamination of the bacterium in the human body. Most patients complain of itching and redness in the area of ​​the genitals and anus. The skin gradually changes into a rash and reddened granulation tissue. They are usually painless, but may bleed if scratched regularly. The disease slowly spreads and destroys the tissue around the genitals. Inguinal folds are often affected – these are the so-called groin folds, which are located between the thighs and the body. The genitals and the skin around them becomes pale and there is pronounced itching. NEWS_MORE_BOX 3. Diagnosis In the early stages, the diagnosis is difficult because the clinical picture resembles mild chancre. At a later stage, the disease takes the form of genital cancer, lymphogranuloma or anogenital amoebiasis. The diagnosis is based on the history of the patient’s sexual lifestyle and examination by the doctor, who finds a painless, reddened rash with granulation tissue on the inguinal folds. A tissue biopsy is performed to demonstrate the presence of an infectious pathogen or neoplastic degeneration of skin cells. A Wright-Giemsa test is also applied, the positivity of which detects Donovan bodies in the tissue sample. These bodies have an oval shape with an upward tip that can be found in the cell cytoplasm or in phagocytes and histiocytes around the affected tissue. 4. Treatment Three-week administration of erythromycin, streptomycin or tetracycline, which are antibiotics with bactericidal action, or 12-week treatment with ampicillin. Rashes disappear already after the first week of treatment, but it is recommended that the course of treatment be completed, as a preventive measure against the recurrence of the condition.