Answer

Granuloma inguinale

(Calymmatobacterium granulomatis)

A 28 year old male presents to the family practice clinic complaining of a painless ulcer on his penis. Physical exam also reveals inguinal lymphadenopathy and suppuration of the lymph node. He has recently traveled to Thailand and admits to having unprotected sex with a lady he met while vacationing there.

Labs: Donovan bodies present. Gram negative rods also seen with stain.

Discussion: The diagnosis of granuloma inguinale by Calymmatobacterium is made by seeing Donovan bodies within large macrophages from the lesion. It is also called Donovanosis and granuloma venereum. It is rare in the US and presents as a painless ulcer on the penis with lymphadenopathy and swelling in the genitalia.

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