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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 transmission of human immunodeficiency virus (HIV).

Donovanosis is a notifiable condition1

How donovanosis is spread

Donovanosis is spread through sexual contact, probably through direct contact with sores. It is usually spread through vaginal or anal sex. Non-sexual spread can occur, including mother to child transmission during delivery.

Signs and symptoms

Signs and symptoms of donovanosis include one or more painless lumps, usually in the genitalia, anal region or groin. The lump(s) slowly gets larger and then ulcerates. 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 secondary bacterial infection occurs.

Complications may include:

  • cancer in the sore
  • destruction of genital tissue
  • 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 spread through the blood to other sites.

Diagnosis

Diagnosis is usually made by laboratory testing on a swab or biopsy 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 probably infectious while sores present.

Treatment

  • 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

  • Avoid close contact until sores are healed.
  • Abstain from sexual activity or use barrier methods (for example, condoms) until sores are healed.
  • Screen for infection in sexual contacts of people with donovanosis. This involves a careful physical examination.
  • Give appropriate antibiotics to newborns of mothers with untreated donovanosis.

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'.

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