Donovanosis (granuloma inguinale) - including symptoms, treatment and prevention

Donovanosis (also known as granuloma inguinale) is caused by a bacterium called Klebsiella granulomatis. Donovanosis occurs in sub-tropical and tropical regions including, rarely, central and northern Australia. Donovanosis is a risk factor for the transmission of human immunodeficiency virus (HIV).

Donovanosis is a notifiable condition1

How donovanosis is spread

Donovanosis is spread through sexual contact, most likely through direct contact with sores. It is usually spread through vaginal or anal sex. Non-sexual infection can occur, including to babies during birth.

Signs and symptoms of donovanosis

Signs and symptoms of donovanosis include one or more painless lumps, usually in the genitals, anal region or groin. The lump(s) slowly gets larger and then becomes and ulcer. These sores typically bleed easily, have a rolled edge and are beefy-red in colour. In some cases the sore has an offensive smell. The sores are usually painless but may become painful if a secondary bacterial infection occurs.

Complications may include:

  • cancer in the sore
  • destruction or breakdown of skin tissue in the genital area
  • narrowing of the vagina, anus or urethra (the tube connecting the bladder to the outside of the body).
  • damage to the bones or bowel if the bacteria spreads through the blood to other sites.

Diagnosis of donovanosis

Diagnosis is usually made by laboratory testing on a swab or biopsy taken from the ulcer. Laboratory tests to exclude other causes of genital ulcers, such as syphilis and genital herpes, should be done.

Incubation period

(time between becoming infected and developing symptoms)

Variable, probably 1 to 16 weeks.

Infectious period

(time during which an infected person can infect others)

Unknown, however most likely infectious while sores present.

Treatment for donovanosis

  • Treat with a prolonged course of appropriate antibiotics until all sores are healed, as ulcers do not resolve without treatment. Follow-up is important as retreatment is needed if recurrence occurs.
  • Safely dispose of any soiled dressings or other articles.
  • Surgery may be needed in cases where treatment is delayed.
  • Screen for other sexually transmitted infections in sexually acquired donovanosis.

Prevention of donovanosis

  • Antibiotics can be given to newborns if exposed to untreated donovanosis during delivery.
  • All sexual partners need to be contacted, tested and treated, if needed. Even if partners have no symptoms they may be able to transmit infection to other sexual partners or reinfect you.
  • Avoid sexual contact until you and any infected partners have completed treatment and the sores have completely healed.
  • Attend follow-up appointments to ensure the infection has been cured.
  • Testing to exclude other sexually transmitted infections is advisable.
  • Use condoms and other barrier methods to prevent getting future sexually transmitted infections, including donovanosis.
  • Get tested for sexually transmitted infections regularly (even if you do not have symptoms), particularly when you have new sexual partners.

Useful links

1 - In South Australia law requires doctors and laboratories to report some infections or diseases to SA Health. These infections or diseases are commonly referred to as 'notifiable conditions'.