Donovanosis is a sexually transmitted infection (STI). Sometimes people call it the “flesh-eating STD” due to its symptoms, but it doesn’t actually eat your flesh. Rather, it causes ulcer-like sores.

Donovanosis, also called granuloma inguinale, is relatively rare. However, you can prevent it, as well as its potentially severe and concerning complications, with STI prevention and early treatment.

Using barrier methods like condoms can help prevent STIs, including donovanosis. Being aware of any unusual symptoms if you’re sexually active and seeking care when you do can also prevent any complications.

Here’s what you need to know about this particular STI.

Donovanosis is caused by a bacterium called Klebsiella granulomatis. Like other types of STIs, donovanosis is transmitted via vaginal, anal, and oral sex.

Donovanosis has been called the “flesh-eating STD” because it causes thick, ulcer-like sores that can eventually damage genital tissues.

When left untreated, nodules and permanent scars may develop. Sometimes this STI is mistaken for genital cancer.

Donovanosis is primarily transmitted from a person who has the infection via vaginal or anal intercourse. It may be transmitted through oral intercourse, too.

In rare cases, donovanosis has been transmitted through nonsexual, skin-to-skin contact.

Transmission from mother to newborn is also possible during childbirth if the mother has an infection.

Donovanosis occurs more often in subtropical or tropical regions of the world. It’s not common in the United States. Most U.S. cases occur as a result of travel to areas where donovanosis is more common.

Once you’ve been exposed to donovanosis, you may start seeing symptoms within 1 to 4 months.

You can help reduce your risk for contracting donovanosis — as well as other STIs — by using barrier methods during sex.

External and internal condoms are preferred preventive measures because they help protect you and your partner(s) from exposure to bodily fluids that may contain the bacteria.

Oral contraceptives like birth control pills or IUDs don’t prevent STIs. Only barrier methods like condoms can prevent STIs.

The only way to completely prevent donovanosis or any other STI is by abstinence. However, you can greatly reduce your risk by using a barrier method:

  • every time you have sex with a new partner
  • when you don’t know your partner’s STI status

If you receive a diagnosis of donovanosis, avoid sexual activity until your doctor determines the infection has fully cleared up.

While anyone who’s sexually active is at risk for STIs, people between the ages of 20 and 40 are at a higher risk for contracting donovanosis.

This particular STI is also more prominent in the following countries and regions:

  • Brazil
  • the Caribbean
  • Southeast India
  • southern Africa
  • Papua New Guinea

If you’ve had sex with someone who developed donovanosis within 60 days, contact your doctor for further instructions. They may recommend treatment even if you’re not showing symptoms of the STI.

Symptoms from donovanosis may include the following:

  • widespread ulcers around the genital area and anus
  • bulging red bumps that may grow in size
  • painless red bumps that bleed and grow back
  • damaged skin
  • loss of genital tissue color
When to seek medical care

Donovanosis needs immediate medical attention to help prevent long-term complications. Your doctor will diagnose your condition based on a physical exam and biopsy from one of the sores. See your doctor right away if you experience:

  • any ulcers in your genital or anal area
  • red bumps that may or may not be painful
  • bumps on your genitals that bleed and grow in size

If you receive a donovanosis diagnosis, it’s important to reach out to your partner(s) so they can get tested, too. This can also help prevent the STI from spreading any further.

The Centers for Disease Control and Prevention (CDC) also recommends HIV testing for all donovanosis cases. This is because having genital sores for any reason may increase the risk of HIV transmission.

Since it’s a bacterial infection, antibiotics can treat it. Your doctor may prescribe one of the following antibiotics:

  • azithromycin (Zithromax, Z-Pak)
  • ciprofloxacin (Cetraxal, Ciloxan, Cipro XR)
  • doxycycline (Doxy-100, Monodox, Targadox)
  • erythromycin (EES Granules, Ery-Tab)
  • trimethoprim/sulfamethoxazole (Bactrim, Bactrim DS, Sulfatrim)

Treatment typically requires a long course of antibiotics, which may last at least 3 weeks or longer. Your doctor will ask you to come in for a follow-up to ensure no new sores have appeared.

Sometimes donovanosis may recur. If this happens, you’ll need a new dose of antibiotic treatment. Relapses may happen 6 to 18 months after the infection seems to clear up.

Surgery may be required to remove leftover scar tissue from the infection. This is most common in cases that receive treatment later on in the infection.

Early treatment is essential in preventing possible complications of donovanosis.

It’s also important that you finish your entire course of antibiotics — even if your symptoms have improved. This helps ensure that the infection is completely cleared.

It may take several months for donovanosis to completely clear up. Left untreated (or undertreated), donovanosis may cause permanent genital:

  • inflammation
  • scarring
  • damage
  • tissue discoloring

It’s also possible for the infection to spread to your pelvis, bones, and internal organs. This STI may even cause damage to the anus, urethra, and bowels. Cancers may occur in untreated genital ulcers.

However, STI prevention and early treatment can avoid these complications.

Contact your doctor right away if you have any early signs or symptoms of donovanosis, or if you recently had sex with someone who developed donovanosis.

Donovanosis is a rare but potentially severe STI that can pose the risk of long-term complications if left untreated. Early detection and proper treatment can prevent any long-term issues, such as permanent genital tissue damage.

Using barrier methods like condoms can help prevent STIs, including donovanosis. If you develop any unusual symptoms, call your doctor for STI testing.