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Granuloma Inguinale -ˌiŋ-gwə-ˈnal-ē, -ˈnäl-, -ˈnāl-

By J. Allen McCutchan, MD, MSc, University of California at San Diego

Granuloma inguinale is a rare sexually transmitted disease caused by the bacteria Klebsiella granulomatis. It leads to chronic inflammation and scarring of the genitals.

Granuloma inguinale is extremely rare in developed countries but still occurs in Papua New Guinea, Australia, southern Africa, the Caribbean, and parts of Brazil and India.


Symptoms usually begin 1 to 12 weeks after infection. The first symptom is a painless, red nodule that slowly enlarges into a round, raised lump. The lump then breaks down to form a sore near the site of the initial infection:

  • Penis, scrotum, groin, and thighs in men

  • Vulva, vagina, and surrounding skin in women

  • Face in both sexes

  • Anus and buttocks in people who have anal intercourse

Sores may spread to other areas. They heal slowly and cause scarring. Occasionally, the infection spreads through the bloodstream to the bones, joints, or liver.


  • Examination of fluid from the sore

Diagnosis is suspected in people who live in areas where the infection occurs and who have sores typical of the infection.

To confirm the diagnosis, doctors take a sample of fluid scraped from the sore and examine it under a microscope.


  • The antibiotic trimethoprim-sulfamethoxazole or doxycycline

  • Testing and treatment of sex partners

Trimethoprim-sulfamethoxazole or doxycycline taken by mouth for at least 3 weeks is effective.

When treated, people usually begin to improve within 7 days. However, if the infection has spread to nearby lymph glands in the groin, healing may be slow and lumps may recur. Then, treatment is required for a longer time. After treatment appears successful, people should be checked periodically for 6 months.

Current sex partners should be examined and, if infected, treated.

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* This is the Consumer Version. *