Donovanosis (granuloma inguinale): a rare cause of osteolytic bone lesions

Extragenital donovanosis of the foot

An extremely rare case of primary extragenital donovanosis affecting the dorsa of right foot is reported. Clinical and histopathological features of the disease are described and the rarity, absence of genital lesions, and consequent difficulty in diagnosis are discussed.

The diagnosis and treatment of donovanosis (granuloma inguinale)

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.

Unusual gynaecological presentations of donovanosis as pseudo-elephantiasis and carcinoma of the cervix

We report 2 unusual gynaecological manifestations of Donovanosis in young tribal aborigines. The first patient presented for medical attention after haemorrhaging from a large pedunculated lesion arising from the left labium minus and majus. This lesion was subsequently confirmed as pseudo-elephantiasis resulting from long-standing Donovanosis of the vulva. The second patient, with initial findings consistent with a diagnosis of advanced cervical malignancy, was referred to the oncology service of a tertiary referral centre. Because of her age and race a differential diagnosis of Donovanosis was considered and subsequently confirmed on special staining (Warthin-Starry) of biopsy specimens. No evidence of malignancy was found in these specimens.

Extragenital granuloma inguinale mimicking a soft-tissue neoplasm: a case report and review of the literature

Granuloma inguinale has been reported to mimic squamous cell carcinoma, as well as sexually transmitted diseases. We describe a rare case of extragenital granuloma inguinale that mimicked a soft tissue neoplasm in an 18-year-old pregnant woman who presented with cervical and labial ulcers. An elective cesarean section was performed, at which time a retroperitoneal mass that involved the right ureter was found. At frozen section, the mass had a xanthogranulomatous appearance consistent with a soft-tissue neoplasm. Special stains of the permanent sections revealed the pathognomic features of granuloma inguinale.

Extragenital donovanosis: three cases from Western Australia

Three unusual cases of extragenital donovanosis are described. The presenting features were ulceration of the anterior abdominal wall, discharging sinuses of the neck, and an abscess of bone, respectively. Two cases were diagnosed recently and were the only instances of extragenital infection in a series of 47 patients with confirmed donovanosis diagnosed at a public health laboratory in Perth, Western Australia, between 1979 and the beginning of 1985. The third case, which occurred in 1977, was found in the records of a major teaching hospital.

Extragenital granuloma inguinale (Donovanosis) diagnosed in the United Kingdom: a clinical, histological, and electron microscopical study

An extremely rare case of primary extragenital granuloma inguinale affecting the axillae is reported. Clinical, histological, and electron microscopical features of the disease are described, and the rarity, absence of genital lesions, and consequent difficulty in diagnosis are emphasised.

Extragenital granuloma inguinale in North Queensland

Two cases of extragenital granuloma inguinale are presented. A 41-year-old female presented with fever, a swollen knee joint and osteolytic lesions involving distal bones, and a 49-year-old male had multiple faecal fistulae in the lower abdomen with extensive involvement of pelvic organs. The diagnostic difficulties presented by such cases and the various types of extragenital pathology that have been described in this disease are discussed.

Granuloma inguinale simulating advanced pelvic cancer

This paper describes a case of multiple disease in an Aboriginal woman. Granuloma inguinale, of unusual severity and extent, which closely simulated advanced pelvic malignant disease, was included. Some problems of the diagnosis are discussed.