Donovanosis (granuloma inguinale)
Show Alternative Names
Granuloma inguinale
Sexually transmitted disease - donovanosis
STD - donovanosis
Sexually transmitted infection - donovanosis
STI - donovanosis
Donovanosis (granuloma inguinale) is a sexually transmitted disease (STD) that is rarely seen in the United States.
Causes
Donovanosis is caused by the bacterium Klebsiella granulomatis. The disease is commonly found in tropical and subtropical areas such as southeast India, Guyana, and New Guinea. There are about 100 cases reported per year in the United States. Most of these cases occur in people who have traveled to or are from places where the disease is common.
The disease spreads mostly through vaginal or anal intercourse. Very rarely, it spreads during oral sex.
Most infections occur in people ages 20 to 40.
Symptoms
Symptoms can occur 1 to 12 weeks after coming in contact with the bacteria.
Symptoms may include:
- Sores in the anal area (in about half of cases)
- Small, beefy-red bumps on the genitals or around the anus
The skin gradually wears away, and the bumps turn into raised, beefy-red, velvety nodules called granulation tissue. They are often painless, but they bleed easily if injured. The disease slowly spreads and destroys genital tissue. Tissue damage may spread to the groin. The genitals and the skin around them lose skin color.
Nodules
Skin nodules are solid or cystic raised bumps in the skin that are wider than 1 centimeter (cm), but less than 2 cm.
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In its early stages, it may be hard to tell the difference between donovanosis and chancroid.
Chancroid
Chancroid is a bacterial infection that is spread through sexual contact.
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Exams and Tests
Tests may include:
- Culture of tissue sample (hard to do and not routinely available)
Culture of tissue sample
A skin or nail culture is a laboratory test to look for and identify germs that cause problems with the skin or nails. It is called a mucosal culture...
ImageRead Article Now Book Mark Article - Scrapings or biopsy of lesion
Biopsy of lesion
A skin lesion biopsy is when a small amount of skin is removed so it can be examined under a microscope. The skin is tested to look for skin conditi...
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Laboratory tests for diagnosing donovanosis are available only on a research basis.
Treatment
Antibiotics are used to treat donovanosis. These may include:
- Azithromycin
- Doxycycline
- Ciprofloxacin
- Erythromycin
- Trimethoprim-sulfamethoxazole
To cure the condition, long-term treatment is needed. Most treatment courses require 3 weeks or until the sores have completely healed.
A follow-up exam is needed because the disease can reappear after it seems to be cured.
Outlook (Prognosis)
Early treatment helps prevent tissue damage or scarring. Untreated, the disease leads to damage of the genital tissue.
Possible Complications
Health problems that may result from this disease include:
- Genital damage and scarring
- Loss of skin color in the genital area
- Permanent genital swelling due to scarring
When to Contact a Medical Professional
Contact your health care provider for an appointment if:
- You have had sexual contact with a person who is known to have donovanosis
- You develop symptoms of donovanosis
- You develop an ulcer in the genital area
Prevention
Avoiding all sexual activity is the only absolute way to prevent an STD such as donovanosis. However, safer sex behaviors may reduce your risk.
Safer sex
Safe sex means taking steps before and during sex that can prevent you from getting an infection, or from giving an infection to your partner....
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The proper use of condoms, either the male or female type, greatly decreases the risk of catching an STD. You need to wear the condom from the beginning to the end of each sexual activity.
Male
A condom is a thin cover worn on the penis during intercourse. Using a condom will help prevent:Female partners from becoming pregnant. Getting an i...
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Female
The female condom is a device used for birth control. Like a male condom, it creates a barrier to prevent the sperm from getting to the egg....
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Review Date:
8/26/2023
Reviewed By
Jatin M. Vyas, MD, PhD, Associate Professor in Medicine, Harvard Medical School; Associate in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, MA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
References
Belda W. Granuloma inguinale (Donovanosis). In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 292.
Eckert LO, Lentz GM. Genital tract infections: vulva, vagina, cervix, toxic shock syndrome, endometritis, and salpingitis. In: Gershenson DM, Lentz GM, Valea FA, Lobo RA, eds. Comprehensive Gynecology. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 23.
Stoner BP, Reno HEL. Klebsiella granulomatis (donovanosis, granuloma inguinale). In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 235.
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