Granuloma inguinale (donovanosis) in women.

A ten-year review (1973-1983) revealed 13 cases of documented granuloma inguinale at Grady Memorial Hospital, Atlanta. The patients' ages ranged from 17 to 77, with the majority in their early 20s. The initial presentation of granuloma inguinale included large, fungating labial ulcers, labial swelling, vaginal discharge, rectovaginal fistulae and hematuria. Common presumptive diagnoses included carcinoma, herpes, syphilis and granuloma inguinale. The final diagnosis was made with cytology and/or tissue examination with the help of special stains to demonstrate the causative organism, Calymmatobacterium granulomatis. Granuloma inguinale is rare and difficult to diagnose, but with physician awareness, cytology and biopsy, it should not be missed.