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Overview

What Is Donovanosis?

Donovanosis, also called granuloma inguinale, is a chronic bacterial sexually transmitted infection (STI) caused by Klebsiella granulomatis. It usually affects the genital area or nearby skin and spreads mainly through direct sexual skin-to-skin contact with an infected lesion. The infection is uncommon in many countries but occurs more often in some tropical and subtropical regions. Without treatment, it can gradually damage surrounding tissue.

Symptoms

Donovanosis Symptoms

  • Small bumps around the genitals may be painless or only mildly painful.
  • The bumps can slowly develop into enlarging, beefy-red ulcers, which are open sores.
  • The ulcers may bleed easily when touched or rubbed.
  • A foul-smelling discharge may come from the affected sores.
  • Lesions can extend from the genitals to nearby skin around the groin or anus.
  • Some people may develop firm raised areas called nodules near the affected skin.
  • Donovanosis symptoms can look different in females and males, depending on which genital or nearby areas are involved.

Important

Pictures cannot confirm the diagnosis

Donovanosis pictures found online cannot confirm whether a sore is caused by this infection. Genital ulcers can result from several infections and noninfectious conditions, so they need prompt examination by a healthcare professional.

How It Spreads

How Donovanosis Spreads

Donovanosis usually spreads through direct sexual skin-to-skin contact with an infected lesion. Transmission is relatively inefficient, and symptoms may not appear until weeks or months after exposure, making the source of infection difficult to identify.

  • Open or fragile lesions can pass Klebsiella granulomatis during close sexual contact with affected skin.
  • Condoms and other barriers can lower risk but may not cover every area with an infectious lesion.
  • Avoid sexual contact while lesions are being evaluated and throughout treatment until they have healed.
  • Recent sexual partners should seek clinical advice so they can discuss symptoms, exposure, testing, and follow-up.

Risk Factors

Donovanosis Risk Factors

  • Sexual contact with a person who has donovanosis or unexplained genital ulcers can increase exposure risk.
  • Living in or traveling to a tropical or subtropical area where donovanosis is more common may increase the likelihood of exposure.
  • Limited access to STI testing and treatment can allow an infection to remain undiagnosed and spread.
  • Having unprotected sexual skin-to-skin contact with an infected lesion may increase risk, although barriers do not cover all skin.
  • A recent partner’s history of genital ulcers or an STI may indicate a need for clinical evaluation.

Donovanosis can occur in people of any sex. Having one of these risk factors does not prove that you have the infection; only a healthcare professional’s assessment and appropriate testing can help determine the cause of genital sores.

Complications

Donovanosis Complications

  • Untreated infection can progressively destroy genital or nearby skin and soft tissue.
  • Healing may cause scarring or narrowing of genital openings.
  • Open ulcers can develop a secondary bacterial infection.
  • Fragile lesions may cause repeated or significant bleeding.
  • Advanced disease can alter the appearance and function of nearby genital tissue.
  • Rarely, infection can spread to other body sites.

Seek care promptly

Do not self-treat genital ulcers

Rapidly enlarging, bleeding, painful, foul-smelling, or spreading ulcers need prompt medical care. Do not rely on over-the-counter products or home treatment, because delaying the correct diagnosis can allow tissue damage or a secondary infection to worsen.

Diagnosis

How Donovanosis Is Diagnosed

A clinician reviews your symptoms, sexual and travel history, and examines the lesions before arranging testing. Because several conditions can cause genital ulcers, the evaluation usually considers donovanosis along with other sexually transmitted and noninfectious causes.

  • A healthcare professional may collect material by scraping the tissue or may take a small biopsy from an ulcer.
  • Microscopic examination may identify Donovan bodies inside cells when the finding is present and the test is available.
  • Molecular or other specialized testing may be used in settings where these methods are available.
  • Testing for syphilis and herpes may help identify other common causes of genital ulcers.
  • Tests for HIV, chlamydia, and gonorrhea may also be recommended based on symptoms and sexual history.

Treatment & Management

Treatment and Management of Donovanosis

Treatment for donovanosis requires prescription antibiotics that are continued until the lesions have fully healed. The exact medicine and treatment duration are selected by a clinician based on your response, medical history, pregnancy or breastfeeding status, allergies, HIV status, and other individual factors.

  • Take the prescribed antibiotics exactly as directed and do not stop early, even if the lesions begin to improve.
  • Attend follow-up visits so healing and any remaining or recurring lesions can be assessed.
  • Avoid sexual contact until treatment is complete and all lesions have healed.
  • Arrange clinical evaluation for recent sexual partners and follow the advice provided about testing or treatment.
  • Tell the clinician if you are pregnant, breastfeeding, have medication allergies, or have HIV so treatment can be selected safely.
  • Keep the affected area clean and follow any wound-care instructions provided by your healthcare professional.

Follow-up matters

Healing may take time

Lesions may improve slowly, and residual scarring or changes in the tissue may remain after treatment. If the lesions do not improve, fail to heal, or return, reassessment is needed to check for resistant infection, an incorrect diagnosis, reinfection, or an underlying condition.

Prevention

Preventing Donovanosis

  • Avoid sexual contact with anyone who has unexplained genital ulcers until they have been medically assessed.
  • Use condoms or other barriers to reduce STI exposure, while remembering that they may not cover all affected skin.
  • Complete the full prescribed treatment and avoid sex until lesions have healed.
  • Inform recent sexual partners so they can seek clinical advice and testing when appropriate.
  • Ask about testing for other STIs after a possible exposure or diagnosis.
  • Seek prompt medical assessment for any new genital, anal, or nearby skin sore.

There is no vaccine for donovanosis, and routine screening of people without symptoms is not generally used to prevent it. Prompt evaluation of genital sores is especially important because early diagnosis and treatment can reduce transmission and tissue damage.

Outlook and Prognosis

Donovanosis Outlook and Prognosis

Most cases respond to the correct antibiotic treatment, but healing can take time. Advanced infection may leave scars, altered anatomy, or other tissue damage even after the bacteria are cleared. Without treatment, donovanosis can continue to progress and may recur if treatment is incomplete or reinfection occurs.

  • Complete the full course of prescribed therapy, even if symptoms improve before the course ends.
  • Attend follow-up appointments to confirm that the lesions are healing properly.
  • Watch for new sores, bleeding, discharge, or other signs that the infection may have returned.
  • Return for evaluation if lesions fail to heal or reappear after treatment.

When Should You See a Doctor

When Should You See a Doctor for Donovanosis?

Seek urgent care

Do not wait with severe symptoms

Seek urgent medical attention for heavy bleeding, rapidly spreading or severely painful lesions, fever, inability to urinate, severe swelling, or signs of a serious secondary infection.

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