Donovanosis: Causes, Symptoms, Diagnosis, Treatment, and Prevention
Donovanosis, also known as granuloma inguinale, is a rare sexually transmitted infection (STI) that causes painful, progressive ulcers on the genitals or between the anus and the genitals. It is caused by a bacterium called Klebsiella granulomatis, which can be transmitted through sexual contact or, rarely, through nonsexual contact. In the absence of treatment, donovanosis can result in scarring, deformity, chronic inflammation, and cancer. In most cases, antibiotics can cure the infection.
Causes of Donovanosis
During sexual activity, the bacterium Klebsiella granulomatis infects the skin and mucous membranes of the genital region, causing donovanosis. The bacterium can enter the body through small cuts or abrasions during sexual activity, or through direct contact with infected lesions. Approximately 100 cases of donovanosis occur in the United States each year, but it is more common in tropical and subtropical regions.
Symptoms of Donovanosis
A donovanosis infection usually develops within one to 12 weeks of exposure to the bacterium, but it may take up to a year for symptoms to develop. There is a painless red bump or nodule on the genitals or the perineum that may bleed easily as a first symptom. The bump gradually grows and breaks down into a large, open sore with irregular edges and a foul-smelling discharge. The sore can spread to other parts of the genitals, such as the anus, the groin, or the thighs. In some cases, the infection can spread to lymph nodes, bones, liver, spleen, and lungs, causing systemic symptoms such as fatigue, fever, and weight loss.
Diagnosis of Donovanosis
The diagnosis of donovanosis is based on the clinical appearance of the lesions and the microscopic examination of tissue samples from the sores. There may be Donovan bodies present in the tissue samples, which are characteristic cells containing the bacterium. However, Donovan bodies are not always visible or easy to find, so multiple tests or biopsies may be required to diagnose. Other tests, such as blood tests, urine tests, or imaging tests, may be performed to rule out other conditions that can cause similar symptoms, such as syphilis, herpes, chancroid, or cancer.
Treatment of Donovanosis
The treatment of donovanosis consists of antibiotics, including azithromycin, doxycycline, erythromycin, or trimethoprim-sulfamethoxazole, which can kill the bacterium and heal the lesions. For three to six weeks, the antibiotics are usually taken orally. Some infections may require longer or repeated antibiotic courses, especially if they are severe or complicated by other infections. It is also possible to remove or repair damaged tissue with surgery and pain relievers. In order to get tested and treated, people with donovanosis should avoid sexual contact until the infection has been cured. They should also inform their sexual partners about their condition.
Prevention of Donovanosis
The prevention of donovanosis involves reducing the risk of exposure to the bacterium and avoiding the transmission of the infection. The preventive measures include:
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Using condoms or dental dams during sexual activity, especially with new or casual partners, or with partners who have symptoms of donovanosis or other STIs.
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Avoiding sexual contact with people who have open sores or lesions on their genitals or the perineum, or with people who have a history of donovanosis or other STIs.
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Seeking medical attention as soon as possible if any symptoms of donovanosis or other STIs develop, and following the prescribed treatment regimen.
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Getting tested regularly for donovanosis and other STIs, especially if sexually active with multiple or high-risk partners, or if traveling to areas where donovanosis is common.
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Practicing good hygiene and keeping the genital area clean and dry.
Summary
It is caused by a bacterium called Klebsiella granulomatis, which can either be transmitted through sexual contact or, rarely, nonsexual contact. It causes painless, progressive ulcers on the genitals or perineum. If left untreated, donovanosis can cause serious complications, such as scarring, deformity, chronic inflammation, and cancer. However, antibiotics can usually cure the infection. As part of the prevention of donovanosis, you should use condoms or dental dams during sexual activity, avoid sexual contact with people who have symptoms or a history of donovanosis or other STIs, get tested for donovanosis and other STIs regularly, and seek medical attention if any symptoms develop.
