title: Disseminated donovanosis (granuloma inguinale) with osteomyelitis of both wrists.
abstract: Donovanosis is a sexually transmitted infection which presents with genital ulceration and inguinal lymphadenopathy. Rarely, it presents with extra-genital manifestations. We present a case of disseminated donovanosis with cervical ulceration, massive pelvic lymphadenopathy, osteomyelitis of the wrists and septic arthritis of the knees and right elbow. A 23-year-old gravida two presented with wasting, oedema, ascites, bilateral iliac lymphadenopathy, anaemia and a large ulcer of the cervix uteri. Two months later in the outpatient clinic, she was much improved but still had post-coital bleeding and a hyperaemic cervix, suggestive of persistent infection. The course of antibiotics was therefore repeated. Histopathological examination of a specimen from colposcopic biopsy of the cervix uteri revealed granuloma inguinale. She improved after several courses of antibiotics, blood transfusion, surgical débridement and aspiration of affected joints.
authors.affiliation: Departments of Obstetris, Gynaecology and Child Health, Pathology and Surgery, Radiology, Anaesthesia and Intensive Care, University of the West Indies, Kingston 7, Jamaica, West Indies. hfletchr@cwjamaica.com
authors.forename: H M
authors.initials: HM
authors.lastname: Fletcher
authors.forename: C A
authors.initials: CA
authors.lastname: Rattray
authors.forename: B
authors.initials: B
authors.lastname: Hanchard
authors.forename: K
authors.initials: K
authors.lastname: Vaughan
authors.forename: W M
authors.initials: WM
authors.lastname: West
mesh_terms: D000328:Adult; D002348:Carpal Bones / Q000000981:diagnostic imaging*; D005260:Female; D006100:Granuloma Inguinale / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D010019:Osteomyelitis / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology; D011859:Radiography