Granuloma inguinale is a sexually transmitted disease that is rarely seen in the United States.

Granuloma inguinale is caused by the bacteria Calymmatobacterium granulomatis. The disease is commonly found in tropical and subtropical areas such as Southeast India, Guyana, and New Guinea, but it occurs on occasion in the United States, typically in the Southeast. There are approximately 100 cases reported per year in the United States.

The disease spreads mostly through vaginal or anal intercourse. Very rarely, it spreads during oral sex.

Men are affected more than twice as often as women, with most infections occurring in people aged 20-40 years. The disease is seldom seen in children or the elderly.

About 50% of infected men and women have lesions in the anal area. Small, beefy-red bumps appear on the genitals or around the anus. The skin gradually wears away, and the bumps turn into raised, beefy-red, velvety nodules called granulation tissue. They are usually painless, but bleed easily if injured.

The disease slowly spreads and destroys genital tissue. Tissue damage may spread to the inguinal folds, the area where the legs meet the torso.

Genitals and surrounding skin has a loss of skin color.

In its early stages, it may be difficult to tell the difference between granuloma inguinale and chancroid. In the later stages, granuloma inguinale may look like advanced genital cancers, lymphogranuloma venereum, and anogenital cutaneous amebiasis.

Granuloma inguinale should be considered if genital lesions have been present for a long time and have been spreading.

Tests that may be done include:

• Scrapings or punch biopsy of lesion
• Culture of tissue sample (difficult to do and not routinely available)

Laboratory tests, such as those used to detect syphilis, are available only on a research basis for diagnosing granuloma inguinale.