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Dermatology

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Question
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A middle aged man presented with ulcerative granuloma on glans. Wright Giemsa stain showed 1-2 rounded structures in macrophage vacuoles. What is the etiologic agent? (AIIMS Nov 2014)



A Chlamydia trachomatis

B Neisseria gonorrheae
C Calymmatobacterium granulomatis

D Staphylococcus aureus

Ans. C
Calymmatobacterium granulomatis

1.Painless ulcer, granulomatous look, bleeding on touch with safety pin appearance of the organism inside the macrophage characterized by PSEUDUBUBOS.

2. Diagnosis

a. The main method of diagnosis is the demonstration of Donovan bodies in either:

b. Cellular material taken by scraping/impression smear/swab/crushing of pinched off tissue fragment on to glass slide

c. Tissue sample collected by biopsy.

d. Smears can be stained with Giemsa, Wright’s stain, or Leishman stain. Biopsies are best stained with silver stains (for example, Warthin-Stary) or Giemsa.

3. Donovan bodies are characterized by

a. Location within large (20-90 µm) histiocytes,

b. Pleomorphic appearance 1-2 × 0.5-0.7 µm,

c. Bipolar densities and a capsule often visible,

d. Stain gram negative.

4. In endemic areas identification of Donovan bodies is achievable in 60-80% of patients considered to have donovanosis on clinical grounds.

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