A 25 year old male presents to the clinic with a lesion on his penis. On examination he was noted to have a beefy red ulcer on the glans which bled when touched. Smear taken from the ulcer showed gram-negative intracytoplasmic cysts filled with deeply staining bodies that had a safety-pin appearance. What is he most likely suffering from?
He is suffering from Granuloma inguinale caused by Klebsiella granulomatis comb nov. The lesion stas as a small painless papule which then ulcerates into a beefy red granulomatous ulcer with rolled edges that bleeds easily. Lesions are most commonly seen on prepuce, coronal sulcus, frenum, and glans in men and on labia minora and fourchette in women. The diagnosis is confirmed by by the presence of Donovan bodies in tissue smears. These are gram-negative intracytoplasmic cysts filled with deeply staining bodies that may have a safety-pin appearance. Chancroid is characterised by the presence of nonindurated, ragged, undermined, painful ulcer associated with painful adenopathy. Ref: O'Farrell N. (2012). Chapter 161. Donovanosis. In D.L. Longo, A.S. Fauci, D.L. Kasper, S.L. Hauser, J.L. Jameson, J. Loscalzo (Eds), Harrison's Principles of Internal Medicine, 18e.
Syphilis
HSV infection
Chancroid
Granuloma inguinale