A 30 year old male patient has a large, spreading and exuberant ulcer with bright red granulation tissue over the glans penis. There was no lymphadenopathy. The most likely causative organism is;

Ans. is 'd' Calymmatobacterium granulomatisRef. Harrison l6th/e p 933 (15th/e p846, p1004, 1005)Bright red painless ulcer with no lymphadenopathy suggest the diagnosis of Donovanosis (caused by Calymmatobacterium granulomatis). Both Treponema (syphilis) and Herpes cause painful ulcers with lymphonodusFeatures of genital ulcer due to DonovanosisThe early primary lesion is a papuleThe no. of lesions can be variableThe edges are elevated and irregularThe lesion is red and velvety and bleeds readilyThere is firms induration and pain is uncommonAbsence of lymphadenopathy, pseudo buboes are seenDiagnosis - It is made by demonstration of Donovan bodies* within large mononuclear cells.T/TDoxycycline - Drug of choice in developed countries Erythromycin - used as an alternative in pregnant women Chloramphenicol - Drug of choice in some developing countries.For the differential diagnosis of genital ulcers see Q no. 74 of May 2001.