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Granuloma
inguinale (donovanosis): an unusual cause of otitis media and
mastoiditis in children. Am J Clin Pathol.1997 Nov;108(5):510-4.
Granuloma
inguinale (donovanosis) is seen predominantly in adults (it rarely
occurs in children) and mainly affects genital skin and mucosa.
Infection occurs at other skin and mucosal sites, and hematogenous
dissemination to bone also has been described. The infection
responds dramatically to appropriate antibiotic treatment. We
present two cases of granuloma inguinale occurring in children (8
months and 5 months of age) causing mastoiditis and external ear
discharges. A temporal lobe abscess also developed in the
8-month-old child. Subsequent computed tomography scans showed
marked improvement in the brain lesion after treatment. The second
child had a polypoid mass in the middle ear that on biopsy showed
the features of granuloma inguinale. The mother of this child had
biopsy-proven granuloma inguinale of the uterine cervix. These cases
indicate that granuloma inguinale can be transmitted during vaginal
delivery, and careful cleansing of neonates born to infected mothers
is recommended.
The diagnosis and
treatment of donovanosis (granuloma inguinale). Genitourin Med.1991
Dec;67(6):441-52
Donovanosis
is a predominantly tropical cause of genital ulcer occurring chiefly
in small endemic foci in all continents except Europe. Diagnosis
requires the careful collection, staining and examination of smears
or biopsies of characteristic genital and, occasionally,
extragenital lesions for demonstration of the pathognomonic Donovan
bodies (Calymmatobacterium granulomatis) within histiocytes.
Successful isolation of C. granulomatis has rarely proved feasible,
the last report being in 1962. Donovanosis has a characteristic
histopathological picture which occasionally simulates epithelioma.
The antibiotics reported as showing good activity in donovanosis are
those with good activity against gram negative bacilli and whose
lipid solubility ensures good intracellular penetration. They
include streptomycin, chloramphenicol, erythromycin, lincomycin,
cotrimoxazole and the tetracyclines. More recently, good results
have been reported with norfloxacin and thiamphenicol. The treatment
of donovanosis in pregnant women and patients with AIDS poses
special problems. Complications of donovanosis such as
elephantiasis, stricture and pelvic abscess may require surgery.
Contacts should be traced for examination but only treated if
lesions are found.
Extragenital
donovanosis in a patient with AIDS. Sex
transm Infect. 1998 Apr;74(2):142-3.
A case
of extragenital donovanosis in a patient with AIDS is reported from
Zimbabwe. Despite the rarity of donovanosis in Zimbabwe it is
important that health workers are familiar with this disease since
donovanosis increases the risk of HIV transmission and appropriate
treatment is often successful even in patients with severe
immunodeficiency.
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