Wednesday, September 08, 2010
This sexually transmitted disease is caused by the gram-negative
bacterium Klebsiella granulomatis. Treatment is directed
against the causative microorganism.
- Azithromycin 1 g orally once weekly for 6 weeks, or until the
ulcer has healed (but for at least 3 weeks).
- Azithromcyin 500 mg daily for 7 days.
For patients intolerant of or in whom the above therapies fail,
try the following for 3 weeks:
- Ciprofloxacin 750 mg twice daily, or
- Sulfamethoxazole/trimethoprim 800/160 (double strength) twice
- Doxycycline 100 mg twice daily
- In refractory cases and for patients with HIV infection,
intramuscular or intravenous gentamicin 1 mg/kg three times daily
may be given for a few days at the beginning of a treatment
- Because of its rarity in most western countries, this diagnosis
is frequently overlooked. Touch preparations and/or biopsies are
required to establish the diagnosis and to rule out a squamous cell
carcinoma in some cases.
- Early discontinuation of treatment leads to more frequent
- Although gentamicin is highly effective, restrict its use to
patients who fail to respond to other safer agents.
- Evaluate the patient for other sexually transmitted