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Bacterial STI Curable

Granuloma Inguinale (Donovanosis)

Granuloma inguinale (donovanosis) is a rare bacterial STI caused by Klebsiella granulomatis. It produces painless, slowly enlarging, beefy-red genital ulcers that bleed easily and are easy to mistake for other conditions. It's very uncommon in the United States but curable with the right antibiotics, and diagnosis usually relies on examining a sample of the ulcer tissue. An unexplained, persistent genital sore is worth evaluating.

Find granuloma inguinale (donovanosis) testing near you When can granuloma inguinale (donovanosis) be detected?
Pathogen
K. granulomatis
Bacterial STI
Curable
Yes
Long antibiotic course
U.S. prevalence
Very rare
Mostly tropical regions
Hallmark sign
Painless ulcer
Beefy-red, bleeds easily

Understanding granuloma inguinale (donovanosis)

What is granuloma inguinale (donovanosis)?

Granuloma inguinale, more commonly known as donovanosis, is a rare bacterial sexually transmitted infection caused by Klebsiella granulomatis. It is very uncommon in the United States, where most clinicians may never see a case. Globally, it is concentrated in a small number of tropical and subtropical regions, and U.S. cases are typically linked to travel or contact within those areas.

The infection is notable for its distinctive ulcers: painless, slowly growing, beefy-red lesions that bleed easily on contact. These sores usually appear on the genitals or perineum. Unlike some other ulcer-causing STIs, donovanosis characteristically does not produce the swollen, tender lymph nodes (buboes) that conditions such as lymphogranuloma venereum or chancroid often cause.

Because donovanosis is so rare in most settings, it is frequently not the first diagnosis considered when a genital ulcer appears. This makes a careful clinical evaluation important: the characteristic appearance of the ulcer, combined with examination of a sample of the lesion tissue, is how the diagnosis is confirmed.

Donovanosis is curable, but treatment requires patience. Antibiotics must be taken for an extended period, at least three weeks and until the lesions have fully healed. Even after apparently effective treatment, the infection can relapse months later, so follow-up matters.

Anyone with a persistent or unexplained genital sore should seek evaluation. Genital ulcers have many possible causes, and accurate identification guides the right treatment and helps prevent transmission to partners.

Where to get tested

Find granuloma inguinale (donovanosis) testing near you

Choose your test and enter your city: we'll take you straight to local granuloma inguinale (donovanosis) testing: nearby clinics and labs, prices, hours and county rates.

Test from home

At-home STD testing in the U.S.

if you'd rather skip the trip, an at-home kit ships to the U.S., you collect the sample privately, and mail it back to a CLIA-certified lab. Results come online in days, with a clinician available if anything is positive. Same labs as a clinic, no waiting room, and you can read how accurate at-home STD tests are before you order.

Want a free option first? The CDC-supported TakeMeHome program mails free at-home HIV self-test kits, and, in many areas, free STI kits, to your door, with no insurance or payment needed. The paid kits below add broader panels and faster turnaround.

  • In-home collection

    Quest Diagnostics

    Quest Diagnostics

    $79 & up

    Panel:
    8-infection panel incl. chlamydia, gonorrhea, HIV, syphilis, hepatitis & herpes: single tests too
    Sample:
    Quest Mobile: a phlebotomist collects your sample at home
    Results:
    1–3 days, online: physician-reviewed
    • In-home sample collection
    • Nationwide Quest lab network
    • Physician-reviewed results
    • FSA/HSA eligible
    Order online Quest Diagnostics review

  • Best range: couples & full panels

    myLAB Box

    myLAB Box

    $79 & up

    Panel:
    Up to 14 infections, incl. HIV, syphilis, chlamydia, gonorrhea, hepatitis & herpes
    Sample:
    Self-collect: swab, urine, finger-prick
    Results:
    2–5 days, online
    • Free phone consult if positive
    • CLIA-certified labs
    • Couples & subscription options
    • Discreet packaging
    Order online myLAB Box review

  • Best value: single tests

    Everlywell

    Everlywell

    $49 & up

    Panel:
    Chlamydia & gonorrhea, up to a 6-test panel adding HIV, syphilis, trichomoniasis & hep C
    Sample:
    Finger-prick + swab
    Results:
    Days, online
    • Telehealth visit if positive
    • CLIA-certified labs
    • HSA/FSA eligible
    • Subscription savings
    Order online Everlywell review

Every kit uses CLIA-certified labs. At-home testing is for screening; a reactive result should be confirmed and treated by a clinician. Prices and panels shown are illustrative and change often, confirm current details on the provider's site.

Symptoms

What are the symptoms of granuloma inguinale (donovanosis)?

Donovanosis is defined by its visible ulcers rather than by silent infection. The lesions themselves are painless, which can delay recognition because the affected person may not feel discomfort prompting them to seek care. Lesions grow slowly over time rather than appearing suddenly. Because the ulcer is painless, it is easy to ignore while it stays contagious, so any unexplained, persistent genital sore is worth a clinician's exam and a tissue sample.

Hallmark ulcer features

  • Painless sores
  • Slowly growing, progressively enlarging lesions
  • Beefy-red appearance
  • Bleed easily when touched
  • Typically located on the genitals or perineum

What is usually absent

  • Swollen lymph nodes (buboes): typically not present, unlike some other ulcer-causing STIs
  • Pain at the ulcer site
  • Sudden onset of multiple lesions

Because the appearance can resemble other genital ulcer diseases, examining a sample of the lesion tissue is used to confirm the diagnosis.

Left untreated

Why granuloma inguinale (donovanosis) is worth catching early

Treated early, granuloma inguinale (donovanosis) is curable and causes no lasting harm. Left untreated, it can cause serious complications:

Progressive tissue destruction

Untreated lesions enlarge slowly and can cause extensive genital scarring and deformity, including lymphedema (pseudo-elephantiasis); early treatment prevents this.

Relapse after treatment

Even after apparently effective treatment, the infection can relapse 6 to 18 months later. Follow-up and awareness of this possibility are important.

How testing works

How a granuloma inguinale (donovanosis) test works

How you test for granuloma inguinale (donovanosis) depends on the infection. The options below cover what each test looks for, how the sample is collected, and where you can get it: at a lab, a clinic, or at home.

When to test

Seek evaluation as soon as a persistent or unexplained genital ulcer appears.

After treatment

There is no routine screening blood test described for donovanosis; diagnosis depends on the appearance of the ulcers and examination of lesion tissue.

Clinical examination of the ulcer First step
Sample
Visual inspection of the genital/perineal lesion
Results
At the visit

Diagnosis begins with recognizing the characteristic beefy-red, painless, easily bleeding ulcer.

Tissue examination Most accurate
Sample
Sample of the lesion tissue
Results
Varies by laboratory

Diagnosis is confirmed by examining a sample of the lesion tissue.

What a granuloma inguinale (donovanosis) test costs

Where What it costs
Private lab (self-pay)Varies by clinic and whether a biopsy or tissue sample is needed.
Free / sliding-scale clinicMany public STI clinics offer evaluation at low or no cost: call ahead, as this rare infection often needs specialist referral.
With insuranceTesting and treatment are commonly covered; confirm with your plan whether the visit is billed as diagnostic.

Compare STD testing costs across every option.

Screening guidance

Who should get tested for granuloma inguinale (donovanosis)?

Testing for granuloma inguinale (donovanosis) is usually guided by symptoms, a known exposure, or a partner's diagnosis rather than routine screening: so you test when you have a reason to, not on a fixed schedule.

  1. 1

    People with an unexplained genital ulcer

    Anyone with a painless, slowly growing, beefy-red sore that bleeds easily on the genitals or perineum should be evaluated, since these are the hallmark features of donovanosis.

  2. 2

    Travelers to endemic regions

    People who have had sexual contact in tropical or subtropical areas where donovanosis is more common should mention this history to their clinician if a genital ulcer develops.

  3. 3

    Sexual partners of diagnosed individuals

    Partners of someone diagnosed with granuloma inguinale should be evaluated, especially if they have had recent contact.

  4. 4

    Anyone with persistent ulcers not responding to other treatment

    If a genital ulcer fails to heal or was initially attributed to another cause, re-evaluation, including tissue examination, can help identify donovanosis.

If your result is positive

How is granuloma inguinale (donovanosis) treated?

Granuloma inguinale is curable but requires a long antibiotic course, continued until all lesions have fully healed.

Treat partners

Sexual partners who had contact within the 60 days before symptom onset should be examined and offered evaluation and treatment.

Re-test after treatment

Relapse can occur 6 to 18 months later even after apparently effective treatment, so monitor for return of lesions and seek re-evaluation if they recur.

Treatment & online care

Resistance note: Treatment should continue until lesions fully heal; stopping early may leave infection that has not resolved.

Prevention

How to prevent granuloma inguinale (donovanosis)

  • Avoid contact with ulcers

    Since the infection spreads through sexual contact and the ulcers transmit the bacteria, avoiding contact with genital sores reduces risk.

  • Evaluate and treat partners

    Having sexual partners evaluated when a diagnosis is made helps interrupt transmission.

  • Complete the full antibiotic course

    Finishing treatment until all lesions heal lowers the chance of unresolved infection and ongoing transmission.

Who is most at risk

Who is most at risk for granuloma inguinale (donovanosis)?

Anyone who is sexually active can contract granuloma inguinale (donovanosis), but certain groups face significantly higher risk, and should test more frequently.

Sexual contact in endemic regions
The infection is concentrated in a few tropical and subtropical regions, so sexual contact in those areas raises the likelihood of exposure.
Contact with an infected partner's ulcers
Because the infection spreads through sexual contact, exposure to a partner's lesions is the primary risk.

Stats & rates

How common is granuloma inguinale (donovanosis) in the U.S.?

Seen mostly in a few tropical and subtropical regions; uncommon in the U.S.

Very rare
in the United States

Where you test and what it costs vary by location, see the by-location links below for granuloma inguinale (donovanosis) testing where you live. Source: CDC, Granuloma Inguinale (Donovanosis), STI Treatment Guidelines.

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Granuloma Inguinale (Donovanosis) testing by state & city

Jump to local granuloma inguinale (donovanosis) testing, clinics and labs, prices and county rates, in your state or a popular city, or explore another test.

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Living with granuloma inguinale (donovanosis)

Questions to ask your provider about granuloma inguinale (donovanosis)

Granuloma Inguinale (Donovanosis) is treatable and nothing to be ashamed of. The most useful next step after a positive result (or before a first test) is a direct conversation with a clinician. Here are the questions that matter most:

  • Since this is often a clinical or biopsy diagnosis, could it be another ulcer like syphilis or chancroid?
  • What treatment options are available to me, and how long until I'm no longer contagious?
  • Should I notify my recent partners, and can your office help me do that confidentially?
  • How long do I take antibiotics (until lesions fully heal), and what does healing look like?
  • Are there other STIs I should test for at the same visit?
  • Can this affect my fertility, pregnancy, or long-term health if left untreated?

Good to Know

Granuloma Inguinale (Donovanosis) testing FAQs

Common questions about granuloma inguinale (donovanosis) and granuloma inguinale (donovanosis) testing, answered.

What is granuloma inguinale (donovanosis)?

Granuloma inguinale, also called donovanosis, is a rare bacterial sexually transmitted infection caused by Klebsiella granulomatis. It causes painless, slowly growing, beefy-red ulcers that bleed easily, usually on the genitals or perineum.

Is donovanosis common in the United States?

No. It is very uncommon in the United States and is seen mostly in a few tropical and subtropical regions.

How does donovanosis spread?

Granuloma inguinale spreads through sexual contact, including contact with the open, bleeding ulcers.

Does donovanosis cause swollen lymph nodes?

Typically not. Donovanosis usually occurs without the swollen lymph nodes that some other ulcer-causing STIs produce, which is one feature that helps distinguish it.

How is donovanosis diagnosed?

Diagnosis is based on the characteristic appearance of the ulcers and is confirmed by examining a sample of the lesion tissue.

Is donovanosis curable?

Yes, it is curable, but it requires a long antibiotic course, azithromycin (1 g once weekly or 500 mg daily) for at least 3 weeks and until all the lesions have fully healed.

Can donovanosis come back after treatment?

Yes. Relapse can occur 6 to 18 months later even after apparently effective treatment, so it's important to watch for recurring lesions and seek re-evaluation if needed.

Are the ulcers from donovanosis painful?

No. The ulcers are characteristically painless. They are beefy-red, grow slowly, and bleed easily on contact.

Medically Reviewed · Updated

Reviewed by Dr. Ngozi Adeyemi, MD, MPH · Infectious Disease & Epidemiology

Board-certified in infectious disease with a focus on STI epidemiology and public-health screening programs. Leads testing, diagnosis and the data-driven 'state of STDs' reporting. Our editorial guidelines →

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