Co-infection with HIV usually causes persistent ulcers for prolonged periods and requires intense and prolonged antibiotic treatment, in comparison with donovanosis patients that are HIV negative.
The differential diagnosis of donovanosis should be done with primary syphilis and some secondary forms (such as condyloma), Ducrey's diseases (principally in its phagedenic form or with a cluster of papules), chronic herpes ulcers, condyloma acuminata (most importantly when large and in a common area), lymphogranuloma (when donovanosis is inguinal and elephantiastic) and spinocellular carcinoma [1,2,25,28].
for example, described the concomitant relationship of donovanosis with syphilis and simple herpes .
Uncommon diagnoses, such as histiocytosis of cells of Langerhans and bipolar aftose can also require a diagnostic differential with donovanosis [35,36].
Inadequate use of antibiotics, whether by dosage or by duration of treatment, makes it difficult or even impossible to diagnose donovanosis with certainty using routine and accessible cytodiagnosis techniques and pathoanatomical exams.
A consensus has not been reached regarding which treatment of donovanosis is best.
In accordance with the CDC and the Brazilian Ministry of Health, doxycycline is the drug of choice for the treatment of donovanosis, and is one of the two best options recommended by the World Health Organization (WHO) (Table 1) [17,18,26].
Azithromycin, according to some authors, is the drug of choice for the treatment of donovanosis, in spite of its high cost [9,17].
Jardim used thiamphenicol for the treatment of donovanosis in the following dosages: 2.
The antibiotics most recently reported for the treatment of donovanosis and recognized as most effective are: ceftriaxone, norfloxacina, trovofloxacina .
A Clinical and Investigational Study of Donovanosis.
Donovanosis in Developed Countries: Neglected or Misdiagnosed Disease?