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

Abstract

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.

• Authors: Pratistadevi K Ramdial, Yetish Sing, Amsha Ramburan, Tesuven K Naidu, Elizabeth Y Samuel, Jayanthilall S Bagratee, Eduardo Calonje
• Journal: The American Journal of dermatopathology (Am J Dermatopathol) Vol. 34 Issue 8 Pg. 818-21 (Dec 2012) ISSN: 1533-0311 [Electronic] United States
• PMID: 23169417 (Publication Type: Case Reports, Journal Article)

Chemical References

• Anti-Infective Agents

Topics

• Anti-Infective Agents (therapeutic use)
• Ear Canal (pathology)
• Ear Diseases (drug therapy, etiology, pathology)
• Female
• Granuloma Inguinale (drug therapy, etiology, pathology)
• Humans
• Infant
• Infectious Disease Transmission, Vertical
• Male
• Polyps (drug therapy, etiology, pathology)