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Donovanosis Treatment Duration — SCE Infectious Diseases MCQ

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ModerateSTIsDonovanosis Treatment DurationSCE Infectious Diseases

A 30-year-old man from West Africa presents with a painless genital ulcer that has beefy red, rolled granulation tissue. It bleeds easily on contact. There is no lymphadenopathy. Tissue crush preparation shows Donovan bodies within macrophages. What is the treatment duration?

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Correct answer: B — Azithromycin 1 g weekly (or 500 mg daily) for at least 3 weeks AND until all lesions have completely epithelialised

Donovanosis (granuloma inguinale, caused by Klebsiella granulomatis) requires treatment for at least 3 weeks AND until complete epithelialisation of all lesions. This is important because premature cessation leads to relapse. Azithromycin is first-line; Doxycycline is an alternative. The 'until healed' criterion distinguishes Donovanosis treatment from other GUD treatments that have fixed durations. Relapse is possible even after apparently adequate therapy, so follow-up until complete healing is essential.

Reference: https://www.nice.org.uk/guidance/conditions-and-diseases/infections