Donovanosis (granuloma inguinale)

Donovanosis or granuloma inguinale is caused by infection with Klebsiella granulomatis, formerly known as Donovania granulomatis, and Calymmatobacterium granulomatis, and was recently renamed following comparative DNA sequencing studies.1 Alternative phylogenetic analyses have argued in favour of retaining the previous species name Calymmatobacterium.2 The infection produces ulceration at the primary site of inoculation which is usually genital but may be oral, anal, or at other extragenital locations. Prominent local lymphadenopathy usually ensues, often leading to further ulcerative lesions in the skin overlying the nodes involved. In the absence of treatment the disease may spread locally and cause lymphoedema and genital mutilation. Rare cases of systemic spread have been reported. Transmission to infants during birth has been reported. The disease is rarely reported in the United Kingdom and patients seen are likely to have lived in one of the main endemic areas, which are currently in India, Papua New Guinea, among Australian aboriginals, Brazil, and South Africa. Screening is recommended only for patients presenting with unusual forms of ulceration where other diagnoses have been ruled out and a suggestive travel history is obtained. Screening of asymptomatic patients attending UK genitourinary medicine clinics is not indicated. Contacts of known cases should undergo careful examination.

RECOMMENDED TESTS FOR SUSPECTED CLINICAL CASES OF DONOVANOSIS

Examination of stained smears for Donovan bodies (evidence level IV, recommendation grade C)

This method was that originally described by Donovan in 19053 and has been …