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Donovanosis

Queensland Health Guidelines for Public Health Units

Revision History

 Version  Date  Changes
1.0 December 2010  Full revision of guideline. 
2.0 April 2015 Full revision of guideline.

Infectious Agent

The infectious agent is Klebsiella granulomatis, formerly Calymmatobacrerium granulomatis, a gram-negative intracellular bacillus.

Notification and Reporting Criteria

Laboratory notification only. Laboratory reporting to NoCS.

For case definitions see http://www.health.gov.au/internet/main/publishing.nsf/Content/cdna-casedefinitions.htm

Public Health Significance and Occurrence

  • Donovanosis is a rare cause of genital ulceration but should be considered in patients returning from areas where the disease may be endemic e.g. PNG, Southern Africa, India and parts of South America.
  • It is primarily sexually transmissible but may be transmitted vertically and by casual contact.
  • Incident cases were found as recently as mid-late 2000s in northern and tropical Australia among Aboriginal and Torres Strait Islander people, but it is now very rare in these areas.
  • The last notified case of Donovanosis in Queensland was in 2010.

It may occur in children aged 1-4 years but the prevalence is highest in adults aged 20-40 years. The male:female ratio is 2.5:1. Affected individuals are usually sexually active. The disease appears to be poorly communicable. It can be confused or coexist with other causes of ano-genital ulceration.

The sequelae of the ulcerative/destructive process associated with this infection can result in stenosis, fistula formation, lymphatic obstruction and secondary infection, all of which can cause considerable morbidity. There is an association between donovanosis and HIV infection, particularly in men with genital ulcers of long duration. Treatment relapses are common and may occur up to 2 years after apparently successful treatment.

 

Clinical Features

See Australian STI Management Guidelines for use in Primary Care

Mode of Transmission

See Australian STI Management Guidelines for use in Primary Care

Investigation

See Australian STI Management Guidelines for use in Primary Care

Management

Cases

See Australian STI Management Guidelines for use in Primary Care

Preventive Measures

General promotion of safer sex practices, including the consistent use of condoms with all sexual partners and avoidance of any sexual contact when anogenital symptoms are present.

Education regarding sexually transmissible infections.

Contact Details of Queensland Health Sexual Health Services

References

Australasian Society for HIV Medicine, 2010. Australasian Contact Tracing Manual (4th ed).

Cohen J & Powderly WG, 2003. Infectious Diseases (2nd ed). Mosby: Washington.

Heymann D. (Ed), 2015. Control of Communicable Diseases Manual (20th ed). 2015. American Public Health Association: Washington.

Holmes KK et al, 2008.  Sexually Transmitted Diseases (4th ed). McGraw, New York.

McMillan A & Scott GR. 2008. Sexually Transmitted Infections (2nd ed.).


Last updated: 14 September 2015