Granuloma Inguinale (Donovanosis) - Symptoms, Causes & Treatment
Medically reviewed by Dr. Anand S. Urhekar, MD, MD Pathology, Clinical Advisor · Last updated July 2026
A sexually transmitted bacterial infection caused by Klebsiella granulomatis, producing slowly progressive, painless, beefy-red genital ulcers that bleed readily on contact. It is rare in most high-income countries but endemic in parts of India, Papua New Guinea, southern Africa and South America.
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Quick Answer
Granuloma inguinale, or donovanosis, is a sexually transmitted infection causing painless, beefy-red genital ulcers that bleed easily and enlarge slowly over weeks. It is rare outside endemic tropical regions. Diagnosis rests on identifying Donovan bodies in a tissue smear or biopsy. Treatment is at least three weeks of azithromycin or another effective antibiotic, continued until the lesions are fully healed, plus partner testing.
Symptoms
- Painless red nodule that ulcerates
- Beefy-red ulcer base that bleeds on contact
- Slow enlargement over weeks to months
- Genital, perianal and inguinal sites
- Scarring, lymphoedema and tissue destruction if untreated
Causes & Risk Factors
- Klebsiella granulomatis infection
- Sexual transmission; low but repeated exposure risk
- Endemic in parts of India, Papua New Guinea, southern Africa, Brazil and Caribbean
- Incubation from one to twelve weeks
Treatment & Management
- Azithromycin for at least 3 weeks and until lesions have fully healed
- Doxycycline, co-trimoxazole or ciprofloxacin as alternatives
- Testing and treating sexual partners from the previous 60 days
- Screening for HIV and other sexually transmitted infections
- Surgical repair for extensive scarring
When to See a Doctor
See a sexual health clinic promptly about any genital ulcer. Painless ulcers still need investigation — syphilis, herpes, chancroid and donovanosis all require different treatment.
Frequently Asked Questions
Why is the ulcer painless?
Donovanosis destroys tissue without producing much acute inflammation or nerve irritation, so ulcers are typically painless — which unfortunately delays people seeking care.
Can it be cured?
Yes, with an adequate antibiotic course continued until healing is complete. Relapse can occur 6–18 months later, so follow-up review is recommended.
Medical References
Information on this page is sourced from and verified against reputable medical resources:
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Medical Disclaimer: This information is for educational purposes only and is not intended as medical advice. The content on this page should not be used to diagnose or treat any health problem. Always consult with a qualified healthcare professional for proper medical evaluation, diagnosis, and treatment of your condition.