Donovanosis is caused by the intracellular Gram-negative bacterium Calymmatobacterium granulomatis. The disease presents clinically as painless, progressive, ulcerative lesions without regional lymphadenopathy. The lesions are highly vascular and can easily bleed on contact. Treatment should be continued until all lesions have completely epithelialized.

Recommended regimen

• azithromycin, 1g orally on first day, then 500mg orally once a day

OR

• doxycycline, 100mg orally, twice daily

Alternative regimen

• erythromycin, 500mg orally, 4 times daily

OR

• tetracycline, 500mg orally, 4 times daily

OR

• trimethoprim (80mg)/sulfamethoxazole (400mg), 2 tablets orally, twice daily for a minimum of 14 days,

Note

The addition of a parenteral aminoglycoside such as gentamicin should be strongly considered for HIV-infected patients.

Follow-up

Patients should be followed clinically until signs and symptoms have resolved.