Granuloma inguinale (donovanosis): an unusual cause of otitis media and mastoiditis in children.
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.
Govender
D
D
Department of Anatomical Pathology, University of Natal Medical School, Congella, Durban, South Africa.
Naidoo
K
K
Chetty
R
R
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001706:Biopsy / Q000379:methods; D002157:Calymmatobacterium / Q000302:isolation & purification; D002584:Cervix Uteri / Q000382:microbiology; D002701:Chloramphenicol / Q000627:therapeutic use; D004432:Ear, Middle / Q000382:microbiology / Q000473:pathology; D005260:Female; D016905:Gram-Negative Bacterial Infections / Q000150:complications / Q000188:drug therapy; D006100:Granuloma Inguinale / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D007223:Infant; D008297:Male; D008416:Mastoid / Q000382:microbiology / Q000473:pathology; D008417:Mastoiditis / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology; D007744:Obstetric Labor Complications / Q000382:microbiology; D010033:Otitis Media / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology; D010406:Penicillins / Q000627:therapeutic use; D011247:Pregnancy; D014057:Tomography, X-Ray Computed
D000900:Anti-Bacterial Agents; D010406:Penicillins; D002701:Chloramphenicol