Donovanosis - A sexually transmitted infection

Heather Little-White, PhD, Contributor

While everyone should be interested in maintaining good sexual health, it is important to be aware of what types of sexually transmitted infections (STIs) are around and how to reduce your risk of getting them. Some STIs are well known, but the more uncommon ones, though little is known about them, are equally as dangerous.

Donovan is a popular name for males, but the name is part of the word, donovanosis (granuloma inguinale), an STI caused by the bacterium organism known as klebsiella granulomatis. The organism is found among the Aboriginal community in places like in the hot, sandy desert areas of Australia. It is also common in southeast India, New Guinea, South Africa, Guyana, and other tropical and subtropical countries (Medline Plus).

The organism was discovered in 1882 by a man named McLeod, who described it as an "ulcerating granuloma of the pudenda". Later, the name originated from the Madras General Hospital, of Major Charles Donovan, a professor and physician working there. He discovered and described the intracellular organisms from the legions in a patient in his care. In 1905, Donovan named the changes in the cells and called them Donovan bodies.

Unprotected sex

How would one contract donovanosis? It is caught by having sex with a person who has the infection. Rarely is it transmitted by oral sex. Donovanosis is contagious, although you may take the chance to have unprotected sex with an infected person and not pick up the infection. If infected, you may have to wait a while to know, as it could take as long as 80 days to show. The infection is more common among men than women and among the age group 20 to 40 years.

The symptoms of donovanosis are easy to detect inside and outside the body. It usually starts out as one or more small lumps or growths in the genital or anal areas of the body and may spread to the groin. These are painless and so the symptoms may be mistaken for chancroid, and in the advanced stage it may be mistaken for genital cancers. It rarely spreads to other parts of the body such as the lungs, mouth, liver and bones. In women, if the growth is on the cervix, it may go unnoticed and grow to a large size during pregnancy and obstruct the normal delivery of the baby from the vagina.

Painless ulcers

The lumps are formed as beefy-red, puffy painless ulcers. As the ulcers get bigger, they bleed once they are touched and women notice blood in the urine at times. The ulcer lends itself to invasion by other bacteria, causing the lesion to become pus-like and smelly and ooze at the surface. The ulcers may resemble those associated with syphilis or cancers.

Diagnosis of the infection is done by microscopic examination of a small piece of the growth which is crushed and placed on a slide. During microscopic examination, the germs responsible for donovanosis appear in groups called 'Donovan bodies', and they resemble safety pins inside the cells.

Antibiotic treatment

A course of antibiotics is usually prescribed for treatment of donovanosis until the ulcers heal. This usually takes a long period of time for complete healing to take place. At the start of the antibiotic treatment, the ulcers will show signs of drying up within three to seven days, but the antibiotics must be taken for the entire period as prescribed or they will come back.

A follow-up examination should be done, as the infection can recur after it appears to be cured. There may be some scarring as a result of the infection, which are white patches of skin. Early treatment is critical to prevent blockage of, or shortening of part of the penis. In some instances, a deep hole may be left at the place of the ulcer.

Partners at risk

Like all other STIs, donovanosis is dangerous and is commonly associated with other highly infectious STIs. It is important that your partner be tested for donovanosis and any other STI. If you are infected, you should abstain from sex until the ulcers are properly healed and you have completed all the medication prescribed.

The skin is designed to keep the body protected against germs that cause sexually transmitted infections. The germs get the opportunity to enter the body if there is a break in the skin which is an excellent defence against the entry of foreign organisms. During sexual intercourse, tiny breaks may occur in the skin causing infection to spread.

Condom use

To prevent donovanosis and other STIs, it is advisable to use a condom all the time with vaginal or anal sex. Avoid sharing sex toys, and a condom could be used with a sex toy for further protection. Regular sexual checks are important. Some sexually transmitted infections do not show early symptoms, so, when in doubt it, is best to get tested. Early diagnosis is critical to successfully treating the infection by medication and lifestyle changes.

The debilitating and deforming nature of the infection and its ability as a risk factor for HIV infection poses challenges to the scientific community, and research will continue into this sexually transmitted infection.