DONOVANOSIS

Causative organism	Klebsiella granulomatis
Incubation period	Weeks to months
How far to trace back	Weeks to months, according to sexual history
Usual testing method	Diagnosis is often made clinically after excluding syphilis; definitive diagnosis requires histology of punch biopsy specimen showing characteristic Donovan bodies or positive nucleic acid amplification testing. Nucleic acid amplification testing maybe performed on surface swab specimens and obviates need for biopsy.
Common symptoms	Relatively painless granulomatous ano-genital lesions Perineum commonly involved with associated ‘pseudo-buboes’ in inguinal region Lesions may ulcerate and bleed Secondary infection produces offensive odour May be mistaken for cancer of vulva or penis
Likelihood of transmission per act of unprotected intercourse	Low
Likelihood of long-term sexual partner being infected	Low-moderate
Protective effect of condoms	Probably low
Transmission by oral sex	Unknown
Duration of potential infectivity	Months to years if active lesions present
Important sequelae	Local tissue destruction, scarring and secondary oedema. Lesions may spread locally, intra-pelvically and to distant anatomic sites. Enhanced HIV transmission
Direct benefit of detection and treatment of contacts	Cure
Usual management of contacts	Counselling, clinical examination and appropriate investigation (Presumptively treat partners) until lesions have healed
Contact tracing priority	High for regular partners. Moderate for casual partners. Donovanosis is now rare in previously endemic areas in Central and Northern Australia following intensive case finding and treatment programs. Always seek specialist support for contact tracing.
Notification	Notifiable by doctors in most Australian states territories and by laboratories in all Australian states and territories Not notifiable in NZ.

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