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July 1977

Tetracycline-Resistant Granuloma Inguinale

Arch Dermatol. 1977;113(7):988. doi:10.1001/archderm.1977.01640070122038

To the Editor.—  I have observed a case of granuloma inguinale in which prolonged treatment with 2 gm of oral tetracycline hydrochloride per day failed to produce clinical or microbiologic response.

Report of a Case.—  A 40-year-old man was admitted to the University of Miami Dermatology service on Sept 6, 1975, for treatment of extensive granuloma inguinale. Ten years prior to admission, he developed a nodule on his left upper inner thigh that later ulcerated and enlarged. He had received numerous courses of oral antibiotics, mostly tetracyclines, but always stopped therapy before healing was complete. His medical follow-up was sporadic. On admission, he had a beefy-red, granular, eroded lesion involving the left upper inner thigh, left inguinal area, base of the scrotum, and the intergluteal and perianal areas. Its border was heaped up and serpiginous. Crush preparations of tissue from the lesion stained with Wright-Giemsa and Warthin-Starry stain showed numerous

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