Hoosen A A, Mphatsoe M, Kharsany A B, Moodley J, Bassa A, Bramdev A
Department of Medical Microbiology, Faculty of Medicine, University of Natal, Durban, South Africa.
Int J Gynaecol Obstet. 1996 May;53(2):133-8. doi: 10.1016/0020-7292(95)02648-7.
A retrospective study to confirm the clinical impression of an increasing prevalence of granuloma inguinale (GI) in women, and to evaluate its association with pregnancy and HIV infection.
Clinical records of all patients with a definitive diagnosis of GI attending the gynecology and antenatal clinics at King Edward VIII Hospital, Durban, South Africa, over a period of 36 months (January 1991-December 1993).
A total of 123 women were diagnosed with GI. The diagnosis was made by tissue smear alone in 21% (n = 26), histology 43% (n = 53) and by a combination of smear and histology in the rest. Forty-two percent (n = 52) were pregnant. The only difference between pregnant and non-pregnant women were the presence of rectal and pelvic lesions in the latter. Sixty-nine percent (n = 36) delivered vaginally while the remaining (n = 16) were delivered by cesarean section. The indications for cesarean section were obstetric except for a patient in labor with extensive untreated vulval granuloma. In the majority (85%) GI had no influence on pregnancy outcome. There was no evidence of congenital GI in the neonates. Twenty-seven percent (30/113) had positive syphilis serology and 16% (18/110) had antibody to HIV. There were no differences in the clinical features and outcome of HIV positive and negative women.
This study shows that GI is increasing in pregnancy in Durban, South Africa. Despite the concern that pregnancy promotes dissemination of GI, such an effect could not be established as the clinical response to treatment and outcome were similar in both pregnant and non-pregnant women. Infection with HIV also did not alter the clinical presentation and outcome of the disease in the patients studied.
进行一项回顾性研究，以证实女性腹股沟肉芽肿（GI）患病率上升的临床印象，并评估其与妊娠和HIV感染的关联。
回顾南非德班爱德华八世医院妇科和产前诊所36个月（1991年1月至1993年12月）内所有确诊为GI的患者的临床记录。
共有123名女性被诊断为GI。仅通过组织涂片确诊的占21%（n = 26），通过组织学确诊的占43%（n = 53），其余通过涂片和组织学相结合的方法确诊。42%（n = 52）为孕妇。孕妇和非孕妇之间唯一的差异是后者存在直肠和盆腔病变。69%（n = 36）经阴道分娩，其余（n = 16）行剖宫产。剖宫产指征均为产科原因，除了一名临产时患有广泛未治疗的外阴肉芽肿的患者。大多数情况下（85%），GI对妊娠结局无影响。新生儿中没有先天性GI的证据。27%（30/113）梅毒血清学呈阳性，16%（18/110）HIV抗体呈阳性。HIV阳性和阴性女性的临床特征和结局没有差异。
本研究表明，在南非德班，妊娠期间GI的发病率在上升。尽管有人担心妊娠会促进GI的传播，但由于孕妇和非孕妇对治疗的临床反应和结局相似，无法证实这种影响。在所研究的患者中，HIV感染也未改变该疾病的临床表现和结局。
