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Donovanosis (Granuloma inguinale): Symptoms and Treatment

Definition

Donovanosis is a sexually transmitted disease with Klebsiella granulomatis, leading to progressive, painless genital ulcers.

Epidemiology of Donovanosis

With declining prevalence, sporadic donovanosis occurs in Papua New Guinea, South Africa, India, and Brazil.

Etiology

The pathogen of donovanosis is Klebsiella granulomatis (old nomenclature Calymmatobacterium granulomatis), a gram-negative and intracellular bacteria.

Signs and Symptoms of Donovanosis

The incubation period is around 50 days. Donovanosis presents with progressive, painless, highly vascular genital ulcers without inguinal lymphadenopathy. The genital ulcers are destructive and can affect the genital organs, the groin, and the perineal region.

**Fig. Granuloma inguinale (Donovanosis):** Figure from Dr. Tabua, Papua, New Guinea. Public Health Image Library, Center for Disease Control and Prevention, USA, https://phil.cdc.gov/.
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Diagnosis

Biopsy from the base of the ulcer shows dark-staining Donovan bodies within large mononuclear cells. NAAT swab tests should rule out chancroid.

Differential Diagnosis

Chancroid and penile tumors.

Treatment of Donovanosis

First choice is Azithromycin 1 g p.o. per week for at least three weeks until complete healing of the ulcers.
Doxycyclin (100 mg 1-0-1), Cotrimoxazol (160/800 mg 1-0-1) or Erythromycin (500 mg 1-1-1-1) are further alternatives.

Chancroid

Index

Genital herpes

Index: 1–9 A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

References

Center for Disease Control and Prevention: “Sexually Transmitted Infections (STI) Treatment Guidelines,” 2021. [Online]. Available: https://www.cdc.gov/std/treatment-guidelines/STI-Guidelines-2021.pdf

IUSTI, “European guideline on donovanosis,” 2016. [Online]. Available: https://iusti.org/wp-content/uploads/2019/12/Donovanosis2016.pdf

Deutsche Version: Granuloma inguinae

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