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Donovanosis — RACP Adult Medicine MCQ

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HardInfectious DiseasesDonovanosisRACP Adult Medicine

A 25-year-old man presents with a painless genital ulcer and bilateral inguinal lymphadenopathy. He has recently returned from Papua New Guinea. Dark-field microscopy of the ulcer exudate is negative. RPR and TPHA serology are negative. A biopsy of the ulcer base shows granulomatous inflammation with intracellular Donovan bodies within macrophages. What is the diagnosis?

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Correct answer: D — Granuloma inguinale (donovanosis)

Donovan bodies (bipolar-staining intracellular organisms within macrophages seen on tissue crush preparation or biopsy) are pathognomonic for granuloma inguinale (donovanosis), caused by Klebsiella granulomatis. It is endemic in tropical regions including PNG and northern Australia. It presents with painless progressive genital ulceration. Treatment is azithromycin 1 g weekly or doxycycline 100 mg BD for at least 3 weeks and until lesions have healed.

Reference: eTG – 2025 – Antibiotic Guidelines; ASHM – 2024 – STI Guidelines