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Donovanosis

Category: Infections and parasites

Topic: Sexually transmissible infections

Quick facts:

  • Donovanosis infection is a rare cause of genital ulcers which can be cured with antibiotics.
  • Donovanosis is mainly a sexually transmissible infection (STI) but can be passed on through skin-to-skin contact and to a baby during birth.
  • For the 5 years to 2022 there were no donovanosis notifications in Queensland.
  • Donovanosis was previously more common in remote areas of Australia and is still widespread in some countries.

Donovanosis is a mildly contagious infection usually transmitted via sexual contact but can be transmitted to a baby during birth or via casual contact. It is caused by the bacterium Klebsiella granulomatis and results in ulcers and destruction of the skin around the genitals, groin or anal area. Donovanosis is extremely rare in Australia. Throughout the world, it is common in tropical and sub-tropical areas, particularly Papua New Guinea, Southern Africa, India, and parts of South America.

Signs and symptoms

After infection, a small painless ulcer, sore or lump develops most commonly in the genital area, but sometimes lesions can appear in the mouth and other parts of the body. This spreads slowly as an ulcer or as a raised red fleshy lump that progressively destroys the skin. A secondary infection can develop which may cause pain, swelling, exudate (pus), or an offensive odour. Common sites of infection are the tip of the penis, the skin just outside of the vagina and the skin around the anus. Symptoms generally appear 1–4 weeks after infection but occasionally take longer to develop.

Testing

Testing for donovanosis is not routinely offered as part of a sexual health check. If you have had sex in countries where donovanosis or other STIs are more common, you should have a sexual health check when you return and mention this to your health provider.

Swabs from the ulcer or sore can be tested for donovanosis at Pathology Queensland laboratories. There are other causes of genital ulcers, so these swabs could be used to test for other causes at the same time. Lesions may also recur, and your doctor may want to review this during treatment and 3 months after treatment is complete.

Treatment

Donovanosis is treated with antibiotics. Depending on the length of time since infection and the stage of infection, antibiotics may need to be taken for several weeks. During this time, it is important to keep ulcers clean and dry and the affected skin away from sunlight. It can take some months for the ulcers or sores to heal.

To ensure the infection has been cured it is important to complete the recommended treatment and that you do not have sex (not even with a condom) until 7 days after the treatment is completed and the doctor has advised that the infection has been cured. Your treating doctor may seek advice from a specialist as donovanosis is so rare.

When people find out they have donovanosis, anyone they have had sex with in the past 6 months will also need to have a sexual health check. This is to make sure they are free of the infection and to prevent re-infection. Sample conversations and services that help with telling partners in a confidential and anonymous way (if desired) are available online:

Transmission

Donovanosis is generally considered to be transmitted via sexual contact, but not always and could be transmitted by close personal contact or faecal contamination. There is a risk of donovanosis if you have sex with someone in a country where donovanosis is still common or a person visiting from that country (e.g. tropical and sub-tropical areas of the world).

Prevention

People should not have sex with someone who has a visible genital ulcer or sore. Genital ulcers or sores could be due to donovanosis or some other STI such as chancroid, herpes or syphilis. If your sexual partner has a genital sore or ulcer, advise them to have a sexual health check.

If you are planning to travel to a country where donovanosis is common, find out about STIs, and how they are best avoided.

Condoms are the best way to prevent STIs and using them with a water-based lubricant will be more pleasurable and reduce the risk of the condom breaking. The only way to know that you do not have an infection is to get a sexual health check. If you have sex with new or different partners and do not use condoms, you'll need to have more frequent sexual health checks.

Health outcome

If donovanosis is not treated, the ulcer will persist and will slowly and progressively get bigger. It can destroy large areas of skin and these can easily become infected with other bacteria. Chronic untreated ulcers can lead to destruction of the local lymph system and swelling of the genitals. Genital cancer may be linked to having untreated donovanosis and skin cancer needs to be considered if genital lesions do not heal with antibiotic treatment or recur.

Donovanosis can be transmitted during vaginal delivery and the baby should be followed closely to watch for lesions that require treatment.

Infections that cause ulcers and sores around the genitals increase the risk of HIV transmission.

Other resources

Related content

Help and assistance

Get qualified health advice 24/7 for the cost of a local call 13 HEALTH (13 43 25 84).

This factsheet provides general information and is not intended to replace the need to see a health professional or have a sexual health check. For more information on donovanosis or sexual health please talk to a healthcare provider. A doctor, nurse or health worker can assist with:

  • providing appropriate tests, treatment and information about how to prevent STIs
  • helping people to ensure that their sexual partners get tested and treated.

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Last updated:
7 March 2023
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