Donovanosis in a child victim of sexual abuse: response to doxycycline treatment.

Donovanosis is a chronic infectious disease caused by the Gram-negative bacteria Klebsiella granulomatis, which mainly affects the skin and mucous membranes of the genital, perigenital, and inguinal regions. Also known as venereal granuloma or granuloma inguinale, it is endemic in tropical and subtropical regions of the globe and often associated with sexual transmission. We report the case of an 11-year-old female victim of chronic sexual abuse, who was diagnosed with donovanosis and presented a good therapeutic response to doxycycline.

Donovanosis in a child victim of sexual abuse: response to doxycycline treatment

Abstract: Donovanosis is a chronic infectious disease caused by the Gram-negative bacteria Klebsiella granulomatis, which mainly affects the skin and mucous membranes of the genital, perigenital, and inguinal regions. Also known as venereal granuloma or granuloma inguinale, it is endemic in tropical and subtropical regions of the globe and often associated with sexual transmission. We report the case of an 11-year-old female victim of chronic sexual abuse, who was diagnosed with donovanosis and presented a good therapeutic response to doxycycline.

Infantile donovanosis presenting as external auditory canal polyps: a diagnostic trap.

Two infants, 6 months and 4 months of age, presented with bilateral or unilateral external auditory canal polyps and otorrhea, respectively. Additional findings on examination included otitis media and mastoiditis. Tympanic membrane perforation was noted in one patient and a postauricular abscess in the other. Incisional biopsies of the polyps and abscess were reported as nonspecific mixed inflammation and abscess wall, respectively. There was a limited response to an empirical 5-day course of trimethoprim sulfamethoxazole. The children were referred to the academic hospital, and excision of the polyps and biopsies of the middle ear, mastoid, and postauricular abscess was undertaken. All the biopsies demonstrated donovanosis. Reappraisal of the initial incisional biopsies also confirmed donovanosis. Trimethoprim sulfamethoxazole was administered to both patients for 3 weeks, with resolution of the lesions. Subsequent investigations confirmed genital tract donovanosis, human immunodeficiency virus seropositivity, acquired immunodeficiency syndrome, and pulmonary tuberculosis in both mothers. Heightened awareness of the occurrence of donovanosis at unusual sites and improved recognition of the histomorphological features of the disease, especially in small and superficial biopsies, are pivotal not only for its correct diagnosis in extragenital cutaneous and extracutaneous locations but also for timely and adequate therapy and an improved infant and maternal outcome.

Donovanosis / Donovanosis

La catedra de Dermatología de la Universidad Nacional Mayor de San Marcos, con sede en el Hospital Nacional "Dos de Mayo" reporta 120 casos de donovanosis entre enero de 1991 y octubre del 2000, cifra que es la más alta de nuestro medio. La donovanosis se ha constituido en la enfermedad transmitida sexualmente como la número uno del síndrome de úlcera genital crónica en los pacientes inmunocompetentes. Ante el conocido rol facilitador de las úlceras genitales en general para la infección por VIH, la donovanosis adquiere vigencia e importancia. Se presenta una revisión detallada con aportes de la experiencia de la consulta médica diaria, tomando en cuenta los aspectos históricos, etiológico, clínico y terapéutico de esta enfermedad.

Granuloma inguinal. Descripción de un caso / Inguinal granuloma. Report of a case

El granuloma inguinal o donovanosis es una infección granulomatosa crónica producida por calymmatobacterium granulomatis, considerada enfermedad venérea clásica, típica de zonas tropicales o subtropicales y excepcional en nuestro país. Es un proceso poco contagioso que evoluciona de forma crónica con elementos vegetantes en zona genital y/o perigenital, sin adenopatías regionales. El agente etiológico puede demostrarse en el estudio dermatopatológico, comprobándose los cuerpos de Donovan mediante las tinciones de Giemsa o Whartin-Starry.El caso de granuloma inguinal que justifica este trabajo apareció en varón caucásico que mantuvo contacto sexual con mujer procedente de las Antillas Holandesas. Se le realizaron múltiples tratamientos antibióticos hasta llegar a la curación aunque posteriormente requirió tratamiento quirúrgico para resolver la fibrosis y el linfoedema residual (AU)

Ulceras genitais na mulher / Female's genital ulcers

O objetivo deste estudo foi a revisäo de aspectos históricos, epidemiológicos, diagnósticos (clinico e laboratorial) e terapêuticos das ulceras genitais de transmissäo sexual de maior frequência (sífilis, cancro mole, donovanose, linfogranuloma venereo e herpes genital)

Granuloma gluteale infantum: case report and review of the literature.

Granuloma gluteale infantum, a benign granulomatous eruption involving the gluteal region, histologically shows a nonspecific dermal inflammatory infiltrate composed of neutrophils, lymphocytes, histiocytes, plasma cells, and eosinophils. It is important to recognize this condition, as it may clinically simulate a neoplastic process. It arises as a complication of primary irritant diaper dermatitis, however, and typically resolves without treatment.

Chancroid and granuloma inguinale.

PIP: Chancroid, also known as soft chancre, is seen infrequently and is manifested locally rather than systemically. The causative organism, Hemophilus ducreyi, is a short nonmotile bacillus, non-acid-fast, and usually gram-negative. Culture of the organism is difficult because contamination by other organisms inhibits the growth of H. ducreyi. Chancroid is relatively rare in the US but is more common in developing countries. It is a disease of the sexually promiscuous and is associated with poor hygiene. The lesions are usually obvious in the male but may be undetected in women. The incubation period is 3-5 days and the typical lesion is a soft nonindurated ulcer with a dirty exudate at the base, which is painful and exquisitely tender to palpation. Bubo formation is common and about half suppurate. Diagnosis depends on differentiation from other genital ulcers. The characteristics of the lesions and the nature of lymph node involvement are diagnostic features; smears and cultures are also involved but the organism may be difficult to isolate and the diagnosis must often be established on clinical grounds alone. In many instances no specific therapy other than cleansing with soap and water may be required. The sulfonamides, tetracycline, or a combination may be utilized. Prevention is usually a function of hygiene; condoms offer good protection. Granuloma inguinale, a disease of tropical and subtropical countries, is caused by the gram-negative, pleomorphic and microaerophilic bacterium Calymmatobacterium granulomatis. The mode of transmission is probably sexual but sexual transmission has been questioned on the basis that the disease is not very contagious. It is likely that a break in the skin or mucosa is necessary for the disease to become established. Lesions occur a few days to 3 months after inoculation in the form of 1 or more indurated papules which gradually break down to form ulcers. The ulceration may spread to the entire genitocrural area if untreated, but systemic disease is very rare. The diagnosis is usually suggested by the history and physical findings but confirmation can be obtained by smears of biopsy and histologic examination. The condition is responsive to a wide variety of antibiotics. Personal hygiene is the most effective means of prevention.^ieng