Studies on Granuloma Inguinale. Vi. Two Cases of Perianal Granuloma Inguinale in Male Homosexuals.

The method of transmission of granuloma inguinale is uncertain but there is an increasing amount of data which indicate that Donovania granulomatis, the organism associated with the disease, has a faecal habitat. One link in the chain of evidence of faecal transmission is the occurrence of granuloma inguinale in male homosexuals, in whom the lesions may be confined to the perianal region. Marmel (1958) presented ten cases of anal granuloma inguinale, of which nine of the patients were homosexuals. He also reviewed the literature and found that, of 48 patients with anal granuloma inguinale for which sufficient information was given, 44 admitted pederasty. Because the occurrence of anal lesions of granuloma inguinale in homosexuals is pertinent to our concept of the transmission of the disease, we now present two further cases of anal granuloma inguinale in homosexuals, with a discussion of the epidemiology of the disease in relation to these findings.