Back to Top Skip to main content Skip to sub-navigation

Surveillance Snapshot: Donovanosis Among Active Component Service Members, U.S. Armed Forces, 2011–2020

Image of This photomicrograph of a tissue sample extracted from a lesion in the inguinal region of the female granuloma inguinale, or Donovanosis patient, depicted in PHIL 6431, revealed a white blood cell (WBC) that contained the pathognomonic finding of Donovan bodies, which were encapsulated, Gram-negative rods, representing the responsible bacterium Klebsiella granulomatis, formerly known as Calymmatobacterium granulomatis. Photo credit: CDC/ Susan Lindsley. This photomicrograph of a tissue sample extracted from a lesion in the inguinal region of the female granuloma inguinale, or Donovanosis patient, depicted in PHIL 6431, revealed a white blood cell (WBC) that contained the pathognomonic finding of Donovan bodies, which were encapsulated, Gram-negative rods, representing the responsible bacterium Klebsiella granulomatis, formerly known as Calymmatobacterium granulomatis. Photo credit: CDC/ Susan Lindsley

Recommended Content:

Medical Surveillance Monthly Report

Donovanosis, or granuloma inguinale, is an uncommon sexually transmitted infection (STI) that is much rarer than chlamydia, gonorrhea, and syphilis. Donovanosis is found mainly in tropical regions, and is highly correlated with populations affected by poverty and lack of access to hygiene and public health infrastructure. However, recent news reports have described donovanosis as a "flesh-eating" STI that may be increasing in incidence in developed countries.1–3

Donovanosis is a bacterial infection of the skin and mucous membranes in the genital region.4–5 Early lesions are small, painless nodules that grow into characteristic "beefy red" highly vascular ulcers and progressively expand. Untreated cases can result in tissue destruction and scarring. Although clinical diagnosis is possible, ulcers may be hard to differentiate from those associated with syphilis, chancroid, HIV-associated herpes, amoebiasis, and carcinoma. For this reason, confirmation via staining of tissue or biopsies is recommended. The causative agent is Klebsiella granulomatis, a gram-negative intracellular bacillus, which produces characteristic Donovan bodies within mononuclear cells upon staining. Antibiotics such as azithromycin, doxycycline, erythromycin, ciprofloxacin, and trimethoprim-sulfamethoxazole are curative over a 3-week course or until sores have healed.

For this analysis, the Defense Medical Surveillance System was searched for records of inpatient and outpatient care for diagnoses of donovanosis. A case was defined by the recording of 1 inpatient or outpatient diagnosis of donovanosis (International Classification of Diseases, 9th Revision Clinical Modification [ICD-9-CM]: 099.2; ICD-10-CM: A58) in the primary diagnostic position. An individual could be counted as an incident case only once during the surveillance period (2011–2020). The surveillance population included all individuals who served in the active component of the Army, Navy, Air Force, or Marine Corps at any time during this period. During the 10-year period, there were 50 incident cases of donovanosis. Cases were split relatively evenly by sex (female service members: 54%; male service members: 46%) and most cases occurred in those aged 20–29 (56%) (data not shown). The annual numbers of cases ranged from 3 to 10 with no discernable trend over time (Figure).

Although the incidence of donovanosis has been very low among service members, it is important for health care providers to be aware of trends of emerging STIs particularly among young, sexually active individuals who may travel to endemic areas. As with other STIs, the best prevention of donovanosis is protected sex.

Author Affiliations: Defense Health Agency, Armed Force Health Surveillance Division (Ms. Daniele and Mr. Wilkerson).

References

1. Purves R. Doctors warning as 'flesh-eating' STI hits UK. Birmingham Live. 21 October 2021. Accessed 22 November 2021. https://www.birminghammail.co.uk/news/health/what-donovanosis-flesh-eating-sti-21924441

2. Lee B. Donovanosis: Why this is called a 'flesh eating' sexually transmitted infection. Forbes. 24 Oct 2021. Accessed 22 November 2021. https://www.forbes.com/sites/brucelee/2021/10/24/donovanosis-why-this-is-called-a-flesh-eating-sexually-transmitted-infection/?sh=423fc60112b4

3. Gardiner, Alistair. Should doctors be concerned over this 'flesh-eating' STD? MDLinx. 4 November 2021. Accessed 22 November 2021. https://www.mdlinx.com/article/should-doctors-be-concerned-over-this-flesh-eating-std/yKQ59ow980YmcCNPqVxiR

4. Satter EK. Granuloma inguinale (donovanosis). Mescape. Updated 25 October 2021. Accessed 22 November 2021. https://emedicine.medscape.com/article/1052617

5. O'Farrell N. Donovanosis. Sex Transm Infect. 2002;78(6):452–457.

FIGURE. Cases of donovanosis among active component service members, U.S. Armed Forces, 2011–2020

You also may be interested in...

Surveillance Snapshot: Norovirus Outbreaks in Military Forces, 2015–2019

Article
8/1/2020
three-dimensional illustration of a single norovirus virion

Surveillance Snapshot: Norovirus Outbreaks in Military Forces, 2015–2019

Recommended Content:

Medical Surveillance Monthly Report

Update: Incidence of Acute Gastrointestinal Infections and Diarrhea, Active Component, U.S. Armed Forces, 2010–2019

Article
8/1/2020
Three-dimensional, computer-generated image of a group of extended-spectrum ß-lactamase-producing Enterobacteriaceae bacteria, in this case, Escherichia coli

Update: Incidence of Acute Gastrointestinal Infections and Diarrhea, Active Component, U.S. Armed Forces, 2010–2019

Recommended Content:

Medical Surveillance Monthly Report

Hearing Conservation Measures of Effectiveness Across the Department of Defense

Article
7/1/2020
An audiology technician at Naval Branch Health Clinic Jacksonville’s occupational health clinic, conducts a hearing exam with Airman Diosney Moraga

Recommended Content:

Medical Surveillance Monthly Report

Surveillance Snapshot: Cervical Cancer Screening Among U.S. Military Service Women in the Millennium Cohort Study, 2003–2015

Article
7/1/2020
Lt. Cmdr. Leslye Green, staff obstetrician and gynecologist, Naval Hospital Pensacola (NHP), uses a model to discuss cervical cancer with a patient

Surveillance Snapshot: Cervical Cancer Screening Among U.S. Military Service Women in the Millennium Cohort Study, 2003–2015

Recommended Content:

Medical Surveillance Monthly Report

Epidemiology of Functional Neurological Disorder, Active Component, U.S. Armed Forces, 2000-2018

Article
7/1/2020
MRI film (iStock.com/temet)

Epidemiology of Functional Neurological Disorder, Active Component, U.S. Armed Forces, 2000-2018

Recommended Content:

Medical Surveillance Monthly Report

Alcohol-Related Emergency Department Visits, Hospitalizations, and Co-Occurring Injuries, Active Component, U.S. Armed Forces, 2009–2018

Article
7/1/2020
Sailors simulate a drunk driving accident

Recommended Content:

Medical Surveillance Monthly Report

Animal-Related Injuries in Veterinary Services Personnel, U.S. Army, 2001–2018

Article
6/1/2020
Soldier and veterinarian assisted by animal care specialist use a stethoscope on a dog

Recommended Content:

Medical Surveillance Monthly Report

Letter to the Editor: G6PD Deficiency in the Tafenoquine Era

Article
6/1/2020
Female Anopheles funestus mosquito that had landed on a human skin surface and was in the process of obtaining its blood meal.

Letter to the Editor: G6PD Deficiency in the Tafenoquine Era

Recommended Content:

Medical Surveillance Monthly Report

Summary of the 2018–2019 Influenza Season Among Department of Defense Service Members and Other Beneficiaries

Article
6/1/2020
A flu shot vaccination sits on a table at 184th Sustainment Command headquarters in Monticello, Mississippi on Feb. 8, 2020. The single best way to prevent seasonal flu is to get vaccinated each year, but good wellness habits like covering your cough and washing your hands often can help prevent the spread of germs. (Mississippi Army National Guard photo by Staff Sgt. Veronica McNabb)

Recommended Content:

Medical Surveillance Monthly Report

Brief Report: Direct Care Cost of Heat Illness to the Army, 2016–2018

Article
6/1/2020
Thermometer

Brief Report: Direct Care Cost of Heat Illness to the Army, 2016–2018

Recommended Content:

Medical Surveillance Monthly Report

Surveillance Snapshot: Illness and Injury Burdens, Recruit Trainees, Active Component, U.S. Armed Forces, 2019

Article
5/1/2020
A Marine Corps Staff Sgt inspects a platoon. (U.S. Marine Corps Lance Cpl. Zachary Beatty)

Recommended Content:

Medical Surveillance Monthly Report

Special Report: Prevalence of Selected Underlying Health Conditions Among Active Component Army Service Members with Coronavirus Disease 2019, 11 February–6 April 2020

Article
5/1/2020
Hospital ship USNS Comfort returns to its homeport after treating patients in New York and New Jersey in support of the COVID-19 pandemic

Recommended Content:

Medical Surveillance Monthly Report

Morbidity Burdens Attributable to Various Illnesses and Injuries, Deployed Active and Reserve Component Service Members, U.S. Armed Forces, 2019

Article
5/1/2020
A physician examines a patient

Morbidity Burdens Attributable to Various Illnesses and Injuries, Deployed Active and Reserve Component Service Members, U.S. Armed Forces, 2019

Recommended Content:

Medical Surveillance Monthly Report

Special Report: Early Use of ICD-10-CM Code “U07.1, COVID-19” to Identify 2019 Novel Coronavirus Cases in Military Health System Administrative Data

Article
5/1/2020
Hospital ship USNS Comfort returns to its homeport after treating patients in New York and New Jersey in support of the COVID-19 pandemic

Recommended Content:

Medical Surveillance Monthly Report

Absolute and Relative Morbidity Burdens Attributable to Various Illnesses and Injuries, Non-service Member Beneficiaries of the Military Health System, 2019

Article
5/1/2020
A Navy doctor examines a young patient

Recommended Content:

Medical Surveillance Monthly Report
<< < ... 6 7 8 9 10  ... > >> 
Showing results 91 - 105 Page 7 of 12
Refine your search
Last Updated: March 25, 2022

DHA Address: 7700 Arlington Boulevard | Suite 5101 | Falls Church, VA | 22042-5101

Some documents are presented in Portable Document Format (PDF). A PDF reader is required for viewing. Download a PDF Reader or learn more about PDFs.