|Description:||This image depicts the penis of a male patient which had been pulled upward revealing an ulcerative wound in the region of the frenulum of the prepuce, or foreskin. The lesion was characterized as a penile subcutaneous granulomata, due to a case of Donovanosis, or granuloma inguinale, a disease caused by the Gram-negative bacterium, Klebsiella granulomatis, formerly known as Calymmatobacterium granulomatis, and even earlier Donovania granulomatis.|
Clinically, the disease is commonly characterized as painless, slowly progressive ulcerative lesions on the genitals or perineum without regional lymphadenopathy; subcutaneous granulomas (pseudobuboes) might also occur. The lesions are highly vascular (i.e., beefy red appearance) and bleed easily on contact. The clinical presentation also can include hypertrophic, necrotic, or sclerotic variants. Extragenital infection can occur with extension of infection to the pelvis, or it can disseminate to intra-abdominal organs, bones, or the mouth. The lesions also can develop secondary bacterial infection and can coexist with other sexually transmitted pathogens.