Granuloma Inguinale (Donovanosis)

Definition

Granuloma inguinale, also known as donovanosis, is a chronic and progressive bacterial ulcerative disease that predominantly affects the skin and mucous membranes of the genital, inguinal, perirectal, and anal regions, often associated with sexual transmission.

Epidemiology

Granuloma inguinale is uncommon but occurs more often in individuals with less access to soap and water for personal hygiene. It is endemic in tropical and subtropical countries such as Papua New Guinea, Australia, Argentina, and Brazil, and sporadic cases are also reported in India and the Caribbean. In South Africa, no cases have been reported for more than a decade, and the disease is very uncommon in the United States.

Donovanosis is generally considered to be primarily a sexually transmitted infection because the main clinical manifestations occur in the genital region. Infectivity is low, however, and multiple sexual contacts with infected partners are necessary to transmit the disease. It typically affects adults ages 20 to 40 years without a gender predilection. Congenital infection has been reported, but the few documented cases of perinatal transmission of donovanosis show an apparent predilection for otorhinolaryngologic structures.