Donovanosis with auto-amputation of penis in a HIV-2 infected person.

Donovanosis is a slowly progressive, granulomatous ulcerative disease , caused by Klebsiella (Calymmatobacterium) granulomatis. The disease is known to persist for years together, leading to complications. A male patient aged 30 years with underlying HIV-2 infection presented to the department of STD with painful ulceration over the genital region of 5 months duration, with absence of penis. Tissue smear from the ulcer and histopathological examination revealed large histiocytes with intracellular Donovan bodies (Pund cell). A final diagnosis of donovanosis with auto-amputation of penis with HIV-2 infection was made. The old conventional medicines, viz. streptomycin, doxycycline and amoxycillin, were effective. Though HIV-2 infections are milder than HIV-1 infections in all aspects, donovanosis in this HIV-2 infected case presented with complications. However, since the CD4 count was 748 cells/cmm, the severity is attributed to the long standing nature and negligence by the patient, and not to possible immunodeficiency.

Facial and oral aspects of some venereal and tropical diseases.

Diseases of the tropical areas include some venereal diseases, and they are still very prevalent in some countries; Brazil is one of them. Very few cases are originated in large cities, as Rio de Janeiro, but at the University Hospital of the Federal University of Rio de Janeiro we also see those patients who come from the interior of the State of Rio de Janeiro or from other states to seek medical care at better equipped hospitals for this type of investigation and therapy. Venereal and tropical dermatoses have many different cutaneous manifestations and may affect skin in several locations. The face is one of the affected areas especially when the disease has a predilection for cartilage, oral and/or nasal mucosa. Alterations observed on the skin of the face and on the mucosa of the mouth of some tropical diseases, such as leprosy, leishmaniasis, paracoccidioidomycosis, donovanosis, and syphilis, as they are observed in Brazil, are presented and discussed in this article.

[24 cases of donovanosis in French Guiana]. / Etude de 24 cas de donovanose en Guyane française.

24 cases of Donovanosis (Granuloma inguinale) have been observed at the Dermatology Clinic of the Centre Hospitalier of Cayenne (French Guyana) between 1970 and 1980, representing a high rate for a 60,000 population. All the patients were coloured people. The disease is more important in the cutaneous parts of the ano-genital areas, than on the mucous parts. The "carcinoid" aspects of some histopathological exams must be considered with the bacteriological research and the very soft clinical aspects. It is often caused by intrarectal sexual contacts whether homo- or heterosexual. The high rate of Donovanosis within the homosexual population is a good argument for an intestinal localisation of the germ Calymnatobacterium granulomatis. All the cases diagnosed show an individual susceptibility to this disease. A deficit of cellular immunity as found in lepromatous leprosy seems a very attractive hypothesis. The treatment with 4 g of streptomycin by day during 5 days or more is considered as the best actually.