A 33-year-old man who has recently emigrated from South Africa is referred to a dermatology clinic with a complaint of sores in his genital region that did not respond to empiric treatment for genital herpes and syphilis. He denies having lymphadenopathy.
On physical examination of the anogenital region, which one of the following findings would be most consistent with a diagnosis of granuloma inguinale?

Figure 1 (Image Series). Granuloma Inguinale - Genital Manifestations
This penis lesion had been present for approximately 40 day prior to the diagnosis of granuloma inguinale. Note the characteristic beefy red appearance.
Source: Centers for Disease Control and Prevention Public Health Image Library CDC/Joe Miller, Dr. Cornelio Arevalo, Venezuela, 1979

Figure 1B. Inguinal Ulcers in Female
These bilateral inguinal buboes ruptured through the overlying skin.
Source: Centers for Disease Control and Prevention Public Health Image Library CDC/Susan Lindsay, 1978.

Figure 1C. Inguinal Ulcers in Female
Source: Centers for Disease Control and Prevention Public Health Image Library CDC/ Dr. Tomkins Tabua, Chief Medical Officer, Port Moresby, Papua, New Guinea

Figure 2. Granuloma Inguinale—Perianal
This photograph taken of a woman with granuloma inguinale shows the characteristic beefy red, highly vascular lesions. These lesions bleed easily with contact.
Source: Centers for Disease Control and Prevention Public Health Image Library: CDC/Joe Miller, 1979
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Question Last Updated
February 4th, 2025
February 4th, 2025
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