Background Also called granuloma inguinale, donovanosis, granuloma venereum Microbiology Gram-negative bacillus
Previously known as Donovania granulomatis and Calymmatobacterium granulomatis Epidemiology Rare, with most cases in Papua New Guinea, KwaZulu-Natal and eastern Transvaal in South Africa, India, Brazil, and Aboriginal communities in Australia Clinical Manifestation Incubation period is unclear, possibly somewhere between 50 days with a wide range from 1 to 360 days
Presents as a firm papule or subcutaneous nodule that eventually ulcerates
Almost all in genitals, but 10% can be inguinal
Case reports of extragenital lesions in lips, gums, cheeks, palate, pharynx, neck, nose, larynx, and chest
Four types:
Ulcerogranulamatous: most common type, shows as a beefy red, non-tender ulcer that bleed
Hypertrophic: raised, irregular edge, sometimes dry
Necrotic: deep ulcer causing tissue destruction and foul odor
Sclerotic: fibrous with scar tissue
Rarely disseminates to liver and bone
Major complication is squamous cell carcinoma Differential Diagnosis Diagnosis Direct microscopy
Swab rolled across lesion then across a slide
Stain with Giemsa, which should show large mononuclear cells with intracytoplasmic cysts fillwed with Gram-negative Donovan bodies
Culture not available
PCR where available
Serology not reliable Management Prevention Neonatal Infection To prevent neonatal acquisition, children born to mothers with donovanosis should be prophylactically treated with azithromycin 20 mg/kg PO daily for 3 days Further Reading
