Quick Answer: Donovanosis is a rare STD that begins as painless red bumps and develops into ulcerative lesions that bleed easily. It’s often misdiagnosed as a bug bite, fungal infection, or herpes. The infection is bacterial and treatable with long-term antibiotics, but diagnosis is delayed in most U.S. cases.
It Didn’t Hurt, So Why Would I Think It’s an STD?
“I’ve had herpes before,” said Mel, 27, “and this didn’t feel like that at all. Herpes burned. This didn’t hurt. It just... opened.” Her story isn’t unique. In fact, that’s the main reason Donovanosis slips past doctors. It doesn’t hurt. It doesn’t cause fever. It doesn’t come with the drama most STDs bring. You’re left with a small sore, maybe a little bleeding, maybe nothing at all. That quiet presentation means most people wait weeks before seeing a doctor, and when they finally do, the doctor often assumes something else.
The early stage looks like a red bump or nodule. Some say it’s soft and raised, others notice a shiny or velvety appearance. Over time, that bump ulcerates. It slowly expands into a beefy red sore that may bleed with contact, especially during sex or even from walking. The edges look rolled and distinct. The inside might seem “clean” or moist. If this sounds medical, it’s because it is, but in the moment, most people just think: weird, but not alarming. And that’s the trap.
Why Donovanosis Keeps Getting Misdiagnosed in the U.S.
Let’s be honest: most U.S. doctors haven’t seen a single case of Donovanosis in their careers. It’s not taught in depth in most medical programs. It doesn’t come up in routine STD workups. It's not part of standard STI panels or urgent care triage. So when a patient comes in with a painless genital sore, they look for more familiar culprits, herpes, syphilis, bacterial vaginosis, even infected hair follicles.
Consider Marcus, a 41-year-old nurse who returned from volunteering in Brazil. He noticed a sore near the base of his penis three weeks after returning. It didn’t itch. It didn’t hurt. His urgent care provider tested him for herpes and HIV, and sent him home with antivirals. The sore got worse. Then it was misdiagnosed as staph. Then MRSA. Not until he went to an infectious disease clinic did anyone ask if he’d been abroad. A tissue smear finally revealed the culprit: Klebsiella granulomatis, the bacteria behind Donovanosis.
In rural areas, or even busy metro clinics, providers often don’t have access to biopsy or smear staining techniques necessary for diagnosis. There's also no FDA-cleared PCR test for this infection in the U.S. Most cases are diagnosed based on appearance, history, and ruling out other infections. That means if your sore doesn’t scream herpes or syphilis, you might be sent away with a cream and a shrug.
How Donovanosis Lesions Compare to Other Infections
One reason for misdiagnosis is visual overlap. A red bump or sore could be anything, from a shaving nick to chancroid to an allergic reaction. But the evolution of Donovanosis lesions makes them distinct over time. Still, without training, the average provider might not spot the difference.
| Condition | Pain Level | Appearance | Healing Pattern |
|---|---|---|---|
| Donovanosis | Usually painless | Beefy red ulcer, rolled edges, bleeds easily | Spreads slowly without treatment |
| Herpes | Moderate to severe pain | Grouped vesicles, blisters, crusting | Heals in 1–2 weeks, recurs periodically |
| Syphilis | Usually painless | Firm, round chancre with clean base | Heals within 3–6 weeks, even without treatment |
| Staph/MRSA | Often tender or painful | Pustules, boils, abscesses | May drain pus, responds to antibiotics |
Donovanosis stands out not because it hurts, but because it doesn't. It’s the slow burn of STDs, growing quietly in the background, giving you every reason to wait... until it's too large to ignore.
Real Voices: Misdiagnosis That Changed Everything
In New Mexico, Keisha, 29, went to three clinics for a non-healing lesion she first noticed after hiking in Arizona. At one point, a provider insisted she had eczema. When she pushed back, asking about herpes, she was told she was being paranoid. “They didn’t even test me. Just gave me a cream and said it would go away.” It didn’t. Months later, with a gynecologist’s help, she received a proper diagnosis, but not before the lesion had spread across her perineum and required over six weeks of antibiotic treatment.
Devon, 38, had just started dating again after a divorce. After a weekend trip with a new partner, he noticed a bump on his foreskin. It didn’t look alarming, so he waited. By the time it ulcerated, he was too embarrassed to get it checked. He searched online, convinced himself it was herpes, and ordered an at-home antiviral kit. Weeks passed, and the lesion worsened. Finally, he saw a doctor, who misdiagnosed him with chancroid. The correct diagnosis came only after he insisted on a biopsy. “I felt crazy,” he said. “Every time I asked questions, I was treated like a hypochondriac.”
These stories aren’t isolated. In a world where even common STDs are misunderstood, rare ones like Donovanosis fall through the cracks. The cost is emotional, physical, and financial. Misdiagnosis doesn’t just delay healing, it chips away at trust, self-esteem, and relationships.
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From Clueless to Critical: When Timing Makes All the Difference
If there's one thread that runs through every Donovanosis misdiagnosis story, it’s this: waiting. Waiting because it didn’t hurt. Waiting because it didn’t look serious. Waiting because no one said otherwise. The window between first noticing something and actually getting the right treatment can stretch for weeks or even months. That delay lets the lesion expand, both in size and in damage.
In Florida, Isaiah, 26, found a sore on his inner thigh two weeks after returning from a backpacking trip through Southeast Asia. “It didn’t hurt. I honestly thought it was a heat rash or friction from my jeans.” After trying cortisone cream, then clotrimazole, and finally a friend’s leftover antibiotics, nothing changed. He visited a clinic in week six. They told him it might be herpes and gave him valacyclovir. It didn’t help. In week ten, a sexual health specialist finally suspected Donovanosis. By then, the lesion was nearly two inches wide and bled on contact. The diagnosis came just in time to avoid surgical debridement.
Isaiah’s story isn’t an anomaly, it’s the rule. The longer Donovanosis goes untreated, the more tissue it consumes. It’s not just a surface infection; the bacteria multiply within macrophages, invading the dermis and creating slow but relentless ulceration. Treatment must continue until the wound is fully healed, not just “looking better.” Early antibiotic intervention can resolve most cases without scarring. Late intervention? That’s when things get complicated.
Treatment that Works, But Only if It’s the Right One
The good news: Donovanosis is curable. The bad news: you probably won’t get the right medication if no one suspects it. Standard treatment includes a long course of antibiotics, most often azithromycin, taken either as 1g once weekly or 500mg daily until full healing. Other effective options include doxycycline, ciprofloxacin, or erythromycin. But the critical point is duration. The treatment doesn't stop after seven days. It continues until every lesion is gone, and re-epithelialization has occurred. That could take three to five weeks or more.
In cases with extensive tissue involvement, patients may need wound care, pain management, or even surgery for cosmetic or functional repair. And because Donovanosis can relapse, especially in immunocompromised individuals, follow-up matters. A patient who walks out the door too soon might be walking back in six months later with a recurrence.
| Medication | Dosage | Duration | Notes |
|---|---|---|---|
| Azithromycin | 500mg daily or 1g weekly | Minimum 3 weeks, until full healing | Preferred regimen due to ease of use and tolerance |
| Doxycycline | 100mg twice daily | 3+ weeks | Contraindicated in pregnancy |
| Erythromycin | 500mg four times daily | 3+ weeks | Less commonly used; GI side effects common |
| Ciprofloxacin | 750mg twice daily | 3+ weeks | Not first-line; used in resistant cases or allergies |
Remember: this isn’t a “take it for 5 days and see if it works” kind of infection. Donovanosis demands patience, and providers who know what they’re treating. That’s why your voice matters in this process. If the sore isn’t healing, if the diagnosis doesn’t sit right, if the meds aren’t working, say something.
The Emotional Toll of Being Misdiagnosed Again and Again
Let’s pause the medical talk for a second. Imagine you’re in pain, not physical pain, but emotional. You’ve gone to a doctor with something intimate and scary, only to be dismissed. Not once, but repeatedly. You’ve been told it’s nothing. Then something common. Then something shameful. You’ve been treated like you’re overreacting. Or worse, ignored. That kind of medical gaslighting chips away at your trust, your confidence, and your ability to self-advocate.
Sierra, 35, said she felt “completely broken” after a nurse rolled her eyes during her second visit for a sore that hadn’t healed. “She said it was probably a hygiene issue,” Sierra recalled. “I shower every damn day. I clean. I trim. I know my body. And I knew something was wrong.” That second visit ended with a prescription for topical steroids. Only after seeing a sexual health nonprofit clinic did Sierra finally get the care she needed.
Misdiagnosis isn’t just a delay. It’s trauma. It’s second-guessing every signal your body sends. It’s wondering if you’re dirty or contagious or broken. It’s telling your partner, “I don’t know what this is,” and seeing the fear flash in their eyes. It’s trying to have sex again after treatment and panicking at every new bump or itch. Donovanosis may be rare, but its emotional aftermath is familiar to anyone who’s ever had their concerns brushed off.
Don’t Wait to Speak Up, Trust Yourself When Something Feels Off
If you’ve read this far, it means you’re probably dealing with something unusual, or afraid that you might be. Maybe there’s a sore that hasn’t healed. Maybe you’ve been diagnosed with three different things and none of the treatments are working. Maybe you’ve been told it’s stress, or friction, or hygiene. Listen: you are not overreacting. You are not imagining it. Your body knows when something is wrong.
Donovanosis isn’t common, but it’s real. And if you’ve traveled to or had sexual contact with someone from a country where it’s more prevalent, India, Papua New Guinea, some Caribbean and South American regions, your risk is higher. But even if you haven’t, rare doesn’t mean impossible. Cases have been diagnosed in people with no travel history at all. Providers who dismiss symptoms because they don’t fit the usual profile are doing a disservice.
Push for a second opinion. Ask for a tissue biopsy or a referral. Bring up the name “Donovanosis.” Mention the bacteria “Klebsiella granulomatis.” These words might prompt your provider to dig deeper. You’re not being difficult, you’re advocating for your health. And if you’re met with resistance, find someone who will listen.
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Donovanosis in the U.S., Why This “Rare” STD Might Be Closer Than You Think
When people hear “Donovanosis,” they think of a disease from the past, or something limited to far-off countries with tropical climates and little medical access. But that’s no longer accurate. In the past decade, public health researchers have started picking up on quiet, scattered cases across the United States, most of them misdiagnosed at first, many slipping through the surveillance cracks entirely.
Let’s be clear: Donovanosis is still classified as a rare disease here. But “rare” doesn’t mean nonexistent. It means underreported, underrecognized, and under-tested. The Centers for Disease Control and Prevention (CDC) stopped tracking Donovanosis separately years ago. It now exists in a sort of blind spot, mentioned in guidelines but not actively monitored. Most diagnoses come only after other options have failed, and many go completely unconfirmed. When providers aren’t looking for it, they won’t find it.
In 2023, a case series from a major metropolitan hospital in Texas described four patients diagnosed within the same six-month period. All had been previously told they had herpes, MRSA, or fungal infections. All had initially gone to urgent care or primary providers. None had traveled abroad. For clinicians who knew what to look for, painless ulcers, slow expansion, bleeding on contact, it was clear. But they admitted in the paper: these cases were likely just the tip of the iceberg.
Experts now believe Donovanosis may be more widespread than official records suggest, especially in underserved communities, immigrant populations, and rural regions where diagnostic tools are limited and sexual health stigma is high. If someone walks into a low-resourced clinic with a genital ulcer and no insurance, they’re unlikely to get a biopsy. They’re far more likely to walk out with antifungals, steroids, or antivirals and be told to “keep an eye on it.” That’s not care. That’s dismissal dressed up as treatment.
When the Body Speaks, And the System Fails to Listen
There’s something uniquely terrifying about knowing something is wrong and being told you’re fine. That kind of gaslighting, intentional or not, creates a rift between the body and the mind. People stop trusting themselves. They stop seeking help. They start blaming themselves for the delay in healing, for their symptoms, for not doing more. But the truth is, the system should be doing more for them.
Lina, 32, told us that by the time she got a Donovanosis diagnosis, she had stopped talking about it to anyone. She felt disgusting. Dirty. “I thought maybe it was punishment,” she said, eyes downcast. “I kept thinking, ‘Why me? What did I do wrong?’” The answer, of course, is nothing. Lina had unprotected sex, just like millions of people do every day. She went to a provider, just like she was supposed to. She followed the advice. And it still got worse.
For people like Lina, Donovanosis is more than a bacterial infection, it’s a mirror reflecting every crack in our medical system. It’s the consequence of teaching future doctors to focus only on the “big three” STDs. It’s the result of a healthcare culture that rewards speed over depth, efficiency over empathy. And it’s preventable. Not just the infection, but the emotional fallout that comes with being misdiagnosed, ignored, and left to spiral alone.
Table: Common Stages of Donovanosis Progression
| Stage | Appearance | Common Mistake | What to Do |
|---|---|---|---|
| Early Nodule | Red bump, painless, no drainage | Bug bite, ingrown hair, friction rash | Monitor closely; if no change in 1 week, seek care |
| Ulceration Begins | Soft open sore, may bleed with friction | Herpes, fungal infection, eczema | Request full STD panel and clinical evaluation |
| Advanced Lesion | Beefy red ulcer with rolled edges, growing | Syphilis, MRSA, cancerous lesion | Ask for biopsy, smear test, infectious disease referral |
| Post-Treatment Phase | Scarring, discoloration, tissue change | Assumed healed infection | Continue follow-up; check for recurrence every 6–12 months |
This isn’t just a clinical chart, it’s a road map of missed opportunities. Each stage offers a window for early intervention, but only if the right questions are asked. Only if someone says, “Wait, this might be something else.” Only if someone believes you.
Sexual Health Deserves More Than Assumptions
The sad truth is that many people never hear the word “Donovanosis” until it’s printed on a lab report, or mentioned quietly after weeks of confusion. That needs to change. Every STD, rare or not, should be part of the conversation when someone presents with an unexplained genital sore. That doesn’t mean creating panic. It means broadening the diagnostic lens. It means taking patients seriously even when their symptoms don’t fit the textbook. Especially then.
If you've ever been told, "It doesn’t look serious,” but it didn’t heal, trust that. If a provider shrugs and says, “We’ll just treat it and see,” but you're on your third prescription, trust that. Donovanosis might be rare, but your health isn’t. It’s yours. And it deserves more than assumptions.
Let’s talk about testing. Donovanosis won’t show up on your routine STD test. It won’t be found in a urine sample or blood draw unless someone is specifically looking for it. Most diagnoses require a smear from the ulcer edge, stained and viewed under a microscope to spot what are known as “Donovan bodies”, the infected cells filled with bacteria. That means you may have to push for it. You may have to explain why you’re concerned. You may have to educate your doctor. That’s not how it should be. But right now, that’s the reality. You’re not being difficult. You’re being thorough. You’re saving yourself weeks, or months, of needless suffering.
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You’re Not Alone, and You’re Not Powerless
It’s easy to feel isolated when your body becomes a mystery, especially when every answer you’re given turns out to be wrong. But the truth is, misdiagnosis is common, even in places where healthcare access is decent. What makes Donovanosis particularly frustrating is that it doesn’t announce itself loudly. It creeps in. It disguises itself. And unless someone knows exactly what to look for, it keeps you in the dark longer than any infection should.
But knowing what it is, and how it works, gives you something powerful: clarity. It gives you the ability to ask for better care, to advocate for better treatment, to reject brush-offs and dismissals. It gives you the vocabulary to say, “I’ve read about Donovanosis. I know it’s rare. But this isn’t going away. And I need you to take it seriously.”
Real people have walked this path and come out the other side. Some with scars, yes. But also with knowledge, strength, and a fierceness they didn’t know they had. They share their stories because they know that someone else is out there, watching a sore grow, doubting their instincts, hoping they’re overthinking it. Let those stories remind you: you are not overthinking it. And you are not alone.
FAQ
1. Can you really get an STD that looks like a bug bite?
Yes, and Donovanosis is the poster child for it. It often starts as a tiny red bump you’d swear came from a mosquito or shaving mishap. But unlike a bug bite, it doesn't itch much, doesn't fade, and eventually morphs into something more serious. If you’ve got a “bite” that’s overstaying its welcome, it might be time to raise an eyebrow.
2. Is Donovanosis painful?
Surprisingly, no. That’s what throws most people off. It doesn’t burn like herpes or throb like an abscess. The sore just sort of... exists. Painless and quiet, which makes it easy to ignore, until it starts bleeding or spreading. By then, you're wondering why the antifungal cream hasn't worked. Pain isn't always the warning sign we wish it were.
3. How long does it take for symptoms to show up?
Anywhere from one to twelve weeks. Sometimes longer. We've heard from people who developed ulcers months after a hookup or trip abroad, which makes tracing the source almost impossible. Just because you didn’t notice it right away doesn’t mean it wasn’t cooking beneath the surface.
4. Do I need a special test to find out if I have it?
Yes, and here’s the kicker: most STD panels won’t catch it. You need a tissue sample or smear from the ulcer itself, examined under a microscope. That means you may have to explain the possibility to your provider, especially if you’ve been traveling or nothing else seems to fit.
5. What if my doctor doesn’t believe me or has never heard of Donovanosis?
Then it’s time to channel your inner badass and self-advocate. Print a page from the CDC. Ask for a second opinion. Mention the term "Donovan bodies." You’re not being dramatic, you’re being thorough. And frankly, you're doing their job for them.
6. Can it come back after treatment?
It can, yes. Even after successful treatment, Donovanosis can relapse, especially within the first year. That’s why follow-up matters. Don’t ghost your provider just because the sore’s gone. Stay in touch, check in, and keep an eye on your body like the brilliant bio-machine it is.
7. Is Donovanosis only in certain countries?
It used to be more common in places like India, Papua New Guinea, and parts of the Caribbean. But now? It’s been showing up in U.S. clinics more often, just usually under the wrong name. Travel history helps, but it's not required to be at risk. The world is connected. STDs don't need a passport.
8. How is Donovanosis treated?
Antibiotics, and a good chunk of time. We're talking at least three weeks, sometimes more, until the lesion fully heals. Azithromycin is the MVP, but doxycycline and others can work too. The key is sticking with it. Don't stop just because it "looks better." You want that wound closed and quiet before you quit.
9. What happens if I ignore it?
It grows. Slowly, steadily, and destructively. Left untreated, Donovanosis can destroy tissue, leave scarring, and open the door for other infections. The longer you wait, the harder it is to treat. Ignoring it doesn’t make it go away, it just gives it more real estate.
10. Can I still have sex if I think I might have Donovanosis?
Let’s be real: it’s not a good idea. You’re putting your partner at risk, and the friction can worsen the sore. Plus, there’s emotional fallout if you pass something unknowingly. Press pause, get clarity, and come back to pleasure when it’s safe and consensual. Trust me, your sex life deserves that.
You Deserve Answers, Not Assumptions
If you've been misdiagnosed, or you suspect you have, take this as your sign to dig deeper. Don’t settle for half-answers. Don’t wait and wonder while the sore gets bigger. Order a discreet at-home test to rule out other infections. Talk to a provider who takes you seriously. Ask about a biopsy. And if something still doesn’t sit right, keep pushing.
This at-home combo test kit checks for the most common STDs discreetly and quickly. While it won’t detect Donovanosis directly, it helps eliminate other possibilities and gives you a solid baseline before you see a specialist.
Don’t wait for things to get worse. Don’t hope it just goes away. Donovanosis may not scream, but your body is speaking. Listen to it. And make sure others do too.
How We Sourced This Article: We combined current guidance from leading medical organizations with peer-reviewed research and lived-experience reporting to make this guide practical, compassionate, and accurate. In total, around fifteen references informed the writing; below, we’ve highlighted some of the most relevant and reader-friendly sources.
Sources
1. CDC – Sexually Transmitted Infections Treatment Guidelines: Donovanosis
2. Cleveland Clinic – Granuloma Inguinale (Donovanosis)
3. NCBI – Donovanosis: Clinical Overview
4. Medscape – Donovanosis Clinical Review
About the Author
Dr. F. David, MD is a board-certified infectious disease specialist focused on STI prevention, diagnosis, and treatment. He blends clinical precision with a no-nonsense, sex-positive approach and is committed to expanding access for readers in both urban and off-grid settings.
Reviewed by: Dr. E. Lanning, MPH | Last medically reviewed: September 2025
This article is for informational purposes and does not replace medical advice.
