What is Donovanosis?
Donovanosis, also called granuloma inguinale, is a sexually transmitted bacterial infection and is caused by the bacteria Klebsiella granulomatis. This infection is rare in the United States since the introduction of antibiotics, but it remains endemic in other countries like Southeast India, Guyana, and New Guinea.
Granuloma inguinale usually affects the skin and mucous membranes in the genital region, where it results in nodular lesions that evolve into ulcers. The ulcers progressively expand and are locally destructive It leads to chronic inflammation and scarring of the genitals.
How it is transmitted
The disease spreads mostly through vaginal or anal intercourse with direct contact with the sores. Very rarely, it spreads during oral sex.
Men are affected more than twice as often as women. Most infections occur in people ages 20-40. The disease is rarely seen in children or the elderly.
Non-sexual spread can occur, including mother to child transmission during delivery.
Symptoms can occur 1 to 12 weeks after coming in contact with the bacteria that cause the disease.
In most cases, the infection affects the genital area, though it can also affect the oral region, face and nose, anus, and chest.
The first symptom is a painless, red nodule that slowly enlarges into a round, raised lump. The lump(s) slowly gets larger and then ulcerates. These sores typically bleed easily, have a rolled edge and are beefy-red in color. In some cases the sore has an offensive smell. The sores are usually painless, but may become painful if secondary bacterial infection occurs.
The sores slowly enlarge and spread to nearby tissue, causing further damage. Sores may also spread when they come into contact with other areas of the body. Without treatment, the sores continue to spread.
Occasionally, the infection spreads to lymph nodes in the groin, causing them to swell, or spreads through the bloodstream to the bones, joints, or liver.
There are four main types of donovanosis infections:
1. ulcerogranulomatous: fleshy red ulcers that easily bleed
2. hypertrophic or verrucous type: ulcer with a raised, irregular edge and a “walnut-like” appearance
3. necrotic: deep, malodorous ulcer that causes severe tissue damage
4. sclerotic or cicatricial: excessive scar tissue
In its early stages, it may be hard to tell the difference between donovanosis and chancroid.
In the later stages, donovanosis may look like advanced genital cancers, lymphogranuloma venereum, and anogenital cutaneous amebiasis.
Testing for donovanosis
It may be donovanosis if genital sores have been present for a long time and have been spreading. Laboratory tests, such as those used to detect syphilis, are available only on a research basis for diagnosing donovanosis.
Still the tests that may be done include:
• Culture of tissue sample although this can be hard to do
• Taking scrapings or punch biopsy of lesions for testing
Treatment of donovanosis
Antibiotics are used to treat donovanosis. To cure the condition requires long-term treatment. Most treatment courses run 3 weeks or until the sores have completely healed.
A follow-up examination is important because the disease can reappear after it seems to be cured.
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.
When treated, people usually begin to improve within 7 days. If the infection, however, has spread to nearby lymph nodes in the groin, healing may be slow and lumps may recur. Then, treatment is required for a longer time. After treatment appears successful, people should be checked periodically for 6 months.
Treating this disease early decreases the chances of tissue damage or scarring. Untreated disease leads to damage of the genital tissue and scaring of the genitals.
Other problems can be:
• The loss of skin color in genital area
• Permanent genital swelling due to scarring
• Cancer can also develop in the scores
• Narrowing of the vagina, anus or urethra can also develop
• Also the disease can lead to damage to the bones or bowels if the bacteria spread through the blood to other sites
• More so, Donovanosis is a risk factor for transmission of HIV as the scores can secrete blood and the be a cause of infection more than just semen.
- More details about STDs such as Chlamydia, HIV, AIDS, Syphilis and the rare STI Lymphogranuloma Venereum
- Read more about the different sexually transmitted diseases, their symptoms, their treatments and the complications they might cause. More so, how you can help to prevent these STDs and STIs from spreading.