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Granuloma Inguinale

Report of Five Cases

Three cases of granuloma inguinale in Negroes who had not been out of the United States were reported from St. Louis by Grindon (1) (1913), but it was not until the report of Symmers and Frost (2) (1920) that the disease with its proved etiology was shown to occur in individuals who had not been out of the United States. Most of the reported cases have been among Negroes but Croker (3), has observed the condition in white individuals.

The exact nature of the etiological agent is still debated. While some agree with Donovan (4) that it is a protozoan and some with Flu (5) that it is a chlamydozoan, there are others among whom are many of the more recent writers who agree with Walker (6) that it is a member of the Friedländer group of bacilli.

None of these cases here reported have been out of the United States. While most of them are from the Southern States, the fact that all of them were treated in Washington, D. C., the nature of their employment and the lack of the disease to incapacitate one for travel and work causes us to realize that the disease is no longer one that can be thought of as being confined to the Negro of the Southern States.

The predominance of males in our small group differs from the usual repeated percentage as recorded by Stitt (7) and Sutton (8).

There is a significant history of gonorrhea either proven or by symptoms in these cases,—the condition appearing to be a related sequelae, the infection occurring at the same time as the gonorrheal infection.

The high percentage of the disease among Negroes is in all probability due chiefly to the lack of personal hygiene and the fact that the disease appears to be endemic among them and not to an inherent racial susceptibility.

Of the various methods of treatment we found that tartar emetic alone or in combination is by far the best and may justly be called a specific for this disease. We cannot, however, make a final report as to permanent cure.

Donovan bodies disappear from the lesion within about two weeks after beginning treatment with tartar emetic. The negative serological test for syphilis together with the failure to improve on salvarsan alone are additional means of differentiating it from syphilis.