Donovanosis
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Donovanosis is a mildly contagious infection usually transmitted via sexual contact but maybe transmitted from mother to baby or via casual contact. It is an infection of the skin around the genitals, groin or anal area caused by the bacterium Klebsiella granulomatis. It causes ulcers and destruction of the skin. Donovanosis is extremely uncommon in Australia, occurring mostly in remote areas of northern Australia. Throughout the world, it occurs commonly in tropical and sub-tropical areas, particularly Papua New Guinea, areas of Central America, southern Africa and southern India.
After infection, a small painless ulcer, sore or lump develops most commonly in the genital area, but sometimes lesions can appear in the mouth and other parts of the body. This spreads slowly as an ulcer or as a raised red fleshy lump that progressively destroys normal skin. A secondary infection may develop which may cause pain, swelling, exudate and an offensive odour may be noticed. Common sites of infection are the tip of the penis, the skin just outside the vagina and the skin around the anus.
Swabs from the ulcer or sore can be tested for donovanosis. There are other causes of genital ulcers, so these swabs could be used to test for other causes at the same time. Antibiotics can be given which will cure the disease. Depending on the length of time since infection and the stage of infection, antibiotics may need to be taken for several weeks. During this time it is important to keep ulcers clean and dry and the affected skin away from sunlight. It can take some months for the ulcers or sores to heal.
To ensure the infection has been cured:
- it is important to take the full treatment, otherwise the infection may not be properly cured
- abstain from sex until the treatment is finished and the doctor has advised that the infection has been cured.
When people find out they have donovanosis, anyone they have had sex with in the past few months will also need to have a sexual health check. This is to make sure they are free of the infection and to prevent re-infection. If anyone feels uncomfortable or embarrassed about telling their partners, a member of the health care team will assist by contacting them on a person's behalf. Names are not mentioned to ensure it is a confidential process. Remember, it is very important for the health of your partners, and the health of other people they have sex with, that this contact tracing occur.
Donovanosis is generally considered to be transmitted via sexual contact, but not always and could be transmitted by close personal contact or faecal contamination. Infections that cause ulcers and sores around the genitals may increase the risk of HIV transmission. Other causes of ulcers or sores need to be considered, before a diagnosis is made.
People should not have sex with someone who has a visible genital ulcer or sore. Genital ulcers or sores could be due to donovanosis or some other STI such as herpes or syphilis. If anyone's sexual partner or intended sexual partner has a genital sore or ulcer, advice that person to have a sexual health check, and refrain from sexual contact until the ulcer has healed.
People planning to visit or live in an overseas country should find out about diseases that occur there and how they are best avoided.
Condom use is encouraged to assist in reducing the risk of obtaining a sexually transmitted infection including donovanosis. People who have more than one sexual partner and do not use condoms should have regular sexual health check-ups.
If donovanosis is not treated, the ulcer will persist and will slowly and progressively get bigger. It can destroy large areas of skin.
For more information on donovanosis, talk to:
- a primary health care centre
- an Aboriginal medical service
- a local doctor
- a sexual health clinic
- a family planning clinic.
