Donovanosis

This condition is a chronic bacterial illness caused by the gram-negative bacillus Klebsiella granulomatis, formerly classified as Calymmatobacterium granulomatis ^[1][2]. It is a sexually transmitted condition predominantly defined by the development of distinctive genital ulcers and has been referenced under numerous historical nomenclatures ^[1].

The infection typically initiates as small, painless nodules roughly ten to forty days post-exposure, which subsequently rupture into open, fleshy red ulcers with rolled margins that bleed readily upon contact ^[1]. These lesions progressively destroy local tissue and may disseminate through autoinoculation, commonly affecting the penile shaft, labia, perineum, or oral cavity ^[1].

The condition remains endemic across numerous developing nations but has demonstrated a marked worldwide reduction in prevalence over recent decades ^[1][2]. Approximately one hundred cases annually are recorded in the United States, while targeted national elimination initiatives have proven successful in other regions ^[1][3]. Historical localized surges such as the Durban epidemic between 1988 and 1997 highlight the necessity for sustained regional monitoring ^[3].

Acquisition occurs primarily through direct sexual contact with infected individuals, particularly those residing in high-prevalence areas ^[1]. The pathogen can additionally propagate locally via autoinoculation or involve the oral mucosa following oral sexual activity ^[1]. Syndromic management protocols often complicate identification due to prior antibiotic use affecting diagnostic detection ^[4].

Effective risk mitigation strategies emphasize consistent barrier protection during sexual encounters, comprehensive sexually transmitted infection screening prior to establishing new partnerships, and the deliberate avoidance of sexual contact with individuals originating from endemic zones ^[1]. Developed countries maintain very low incidence rates due to the availability of effective antibiotic treatments ^[1].

1. 1Wikipedia contributors. Granuloma inguinale - Wikipedia [Internet]. Wikipedia. cited 2 Sept 2026.Available from: https://en.wikipedia.org/wiki/Granuloma_inguinale
2. 2O'Farrell N et al. Donovanosis. Clin Dermatol. 2026 Jan-Feb. PMID: 41016613. doi: 10.1016/j.clindermatol.2025.09.007.PubMed: https://pubmed.ncbi.nlm.nih.gov/41016613/
3. 3O'Farrell N et al. Donovanosis. Sex Transm Infect. 2002 Dec. PMID: 12473810. doi: 10.1136/sti.78.6.452.PubMed: https://pubmed.ncbi.nlm.nih.gov/12473810/
4. 4Velho PE et al. Donovanosis. Braz J Infect Dis. 2008 Dec. PMID: 19287842. doi: 10.1590/s1413-86702008000600015.PubMed: https://pubmed.ncbi.nlm.nih.gov/19287842/