Donovanosis: ‘Flesh-eating’ STI has doctors worried

Donovanosis causes thick ulcers on the genitals. Both men and women can contract it, but men are twice as likely to be affected. It is generally transmitted through unprotected sex.

Also called granuloma inguinale, donovanosis is a bacterial infection that has been dubbed “flesh-eating” because it causes extensive inflammation of the genitals. It does not actually eat the flesh.

Typical initial symptoms are itchy sores or raised lumps in the genital and anal areas that increase in size and have a “beefy red” appearance. These can develop into ulcers that can become infected. If left untreated, donovanosis attacks and gradually destroys the genital tissue, causing scarring.

An infection from the tropics

Donovanosis is found mainly in tropical areas, in countries such as India, Papua New Guinea, and central and northern Australia. Cases have also been reported in Vietnam and some African countries.

It belongs to the category of STIs or sexually transmitted infections. In Europe, it remains rather rare, with chlamydia, syphilis or even gonorrhea still topping the list of the most common STIs.

Now, however, some doctors in the UK are warning that donovanosis is spreading in the country, with cases ticking up.

• 7 of the deadliest superbugs

  Klebsiella pneumoniae

  Approximately 3-5% of the population carry Klebsiella pneumoniae. But most people can carry it without becoming sick. It’s different for those with a weakened immune system or acute infections. They could suffer severe gastrointestinal infections, pneumonia, blood poisoning — it depends on where the bacteria settles. Klebsiella pneumoniae is a critical-priority drug-resistant bug, says the WHO.

• 7 of the deadliest superbugs

  Candida auris

  Making headlines in the US at the moment, Candida auris is an emerging fungus that’s proving multidrug-resistant to antifungal medication commonly used to treat Candida infections. It’s appeared on five continents so far and been so hard to get rid of some hospitals have had to close down to eliminate it. Healthy people aren’t usually infected, but those who are unwell or need surgery are at risk.

• 7 of the deadliest superbugs

  Pseudomonas aeruginosa

  This highly resistant, “nightmare bug” has been classified by the WHO as one of the biggest threats to human health. Thriving in wet or moist places, it’s one of the hardest bacteria to eradicate. It’s usually only seen in people with weakened immune systems, but healthy people can also get ear and skin infections if they come into contact with it, especially after being around contaminated water.

• 7 of the deadliest superbugs

  Neisseria gonorrhea

  There’s no vaccine for gonorrhea, so antibiotics are the only option for treating infections. But this sexually-transmitted disease is increasingly resistant to the drugs — azithromycin, cefixime and ceftriaxone — normally used to treat it. Two cases of so-called super gonorrhea were reported in Australia in 2018 and another two in the UK in early 2019. Another good reason to always wear a condom!

• 7 of the deadliest superbugs

  Salmonellae

  This bug is best known for causing non-typhoidal foodborne infections, but it can also cause typhoid fever in humans. In the last few decades, a highly virulant, antibiotic-resistant strain has emerged. Spread through contaminated food and water, regions including Asia and Africa are experiencing epidemics of the drug-resistant bacteria.

• 7 of the deadliest superbugs

  Acinetobacter baumannii

  Ranked in the highest-risk category of pathogens by the WHO, this bug is commonly found in soil and water and can take on genes from other resistant bacteria. It’s able to survive in healthy patients without causing symptoms, but can cause deadly lung, blood and wound infections in unwell patients. This is why outbreaks of Acinetobacter infections are usually seen in intensive care units.

• 7 of the deadliest superbugs

  Drug resistant tuberculosis

  Myobacterium tuberculosis is one of the world’s leading infectious diseases, causing more than 1.7 million deaths each year. It’s estimated that up to 13 percent of all new tuberculosis cases are multidrug-resistant — unresponsive to two of the most potent treatments — and six percent are extensively drug-resistant, unresponsive to even more. These sufferers are more likely to get diseases or die.

  Author: Charli Shield

This is how donovanosis progresses

Since donovanosis does not cause pain, it is often not recognized directly. Reddish nodules form at the site where the bacteria enter the body. But they disappear relatively quickly. Ulcers then develop near the affected area. They bleed when touched. They can appear on different parts of the body, but they usually affect the genitals.

In men, the penis is affected, and in women, the labia. If the infection is not treated early, it leads to pus-filled inflammation that eventually damages the genital tissue. The incubation period is nonspecific, with anywhere between one and 16 weeks between the actual infection and the outbreak of donovanosis.

Diagnosis via a smear test or biopsy

Most people who contract donovanosis are between 30 and 40 years old. To diagnose the infection, the doctor takes a smear from the affected part of the body or a tissue sample. If that does not bring a clear result, a cell culture of the ulcer can be done.

That can also help the doctor determine whether it is actually donovanosis or another STI with similar symptoms. That includes syphilis, for example.

Early treatment is important

Once donovanosis is confirmed, the doctor usually treats the patient with antibiotics. If that happens relatively quickly, the infection can clear up completely.

If it is already at an advanced stage, the infection could, however, lead to edema or swelling, the urethra, vagina or anal canal can narrow and there can be permanent scarring.

In such cases, surgery is the only solution. The body does not build up immunity against a new infection. That means even after having donovanosis, the patient is not protected.

Condoms provide protection against transmission

As with almost all sexually transmitted infections, condoms offer the best protection. Using them is particularly recommended when traveling to tropical and subtropical countries where the bacterial infection is often endemic.

Experts say condoms provide good protection against sexually transmitted infections and diseases

In Germany, public health agency Robert Koch Institute, among others, provides information about donovanosis and other STIs that can become an unwanted souvenir when traveling abroad.

This article has been translated from German.

Article source: https://www.dw.com/en/donovanosis-flesh-eating-sti-has-doctors-worried/a-59669139?maca=en-rss-en-all-1573-rdf