Diagnosis is often based on identification of typical Donovan bodies (gram-negative intracytoplasmic cysts filled with deeply staining bodies that may have a safety-pin appearance) within large mononuclear cells in smears from lesions or biopsy specimens. PCR is also available.
Treatment: Donovanosis (Klebsiella Granulomatis Infection) Pts should be treated with azithromycin (1 g on day 1, then 500 mg qd for 7 days or 1 g weekly for 4 weeks); alternative therapy consists of a 14-day course of doxycycline (100 mg bid), trimethoprim-sulfamethoxazole (960 mg bid), erythromycin (500 mg qid), or tetracycline (500 mg qid). If any of the 14-day treatment regimens are chosen, the pt should be monitored until lesions have healed completely. |
Section 7. Infectious Diseases