ABSTRACT
Os autores apresentam imagens de duas formas clínicas mais frequentes da Donovanose, em ambos sexos. A donovanose é considerada uma doença sexualmente transmissível, endêmica nas regiões tropicais e semitropicais do globo. Apresentam também imagens de duas lâminas: uma da pesquisa direta (corpúsculos de Donovan, dentro de grandes células mononucleadas coradas de vermelho pelo Giemsa) e outra de achados histológicos típicos (formato de alfinete dentro do histiócito).
The authors present images of two of the most common clinical forms of granuloma inguinale (donovanosis) in males and females. Donovanosis is considered a sexually transmitted disease that is endemic in tropical and subtropical regions of the world. Two microscopic images are also shown, one of a direct smear (the presence of Donovan bodies within large mononuclear cells identified using Giemsa stain) and the other of typical histological findings (rod-shaped Donovan bodies within a mononuclear histiocyte).
Subject(s)
Female , Humans , Male , Calymmatobacterium , Granuloma Inguinale/pathology , Azure Stains , Staining and LabelingABSTRACT
La Donovanosis es una enfermedad ulcerativa crónica y progresiva que ataca por lo común la región genital, es producida por el Calymmatobacterium granulomatis, bacteria Gram negativa. La Azitromicina ha emergido como la droga de elección para su tratamiento. Se presenta un caso de Donovanosis en un varón de 46 años, quien tenía relaciones heterosexual y homosexual, el cuál presento papula anal que evoluciono a una úlcera crónica, le realizan el diagnostico de tumoración anorrectal a descartar una neoplasia anorrectal y le realizan colostomía. El retardo en la sospecha clínica en un área no endémica concluyo con su diagnóstico con un extendido en lámina para microscopia con coloración Giemsa.
Donovanosis is a chronic and progressive ulcerative disease that frequently attacks the genital region. It is produced by the gram negative bacteria Calymmatobacterium granulomatis. Azythromycin has emerged as the drug of choice for its treatment. We present one DonovanosisÆ case in a 46-year-old male, who had heterosexual and homosexual intercourse. He presented anal papulae that evolved to a chronic ulcer. He was diagnosed as having an anal and rectal tumor, and colostomy was performed to discard neoplasia. Delay in clinical diagnosis in a non endemic area concluded with diagnosis by Giemsa stain of a sample and microscopic observation.
Subject(s)
Humans , Male , Calymmatobacterium , Sexually Transmitted Diseases , Granuloma InguinaleABSTRACT
FUNDAMENTOS - A donavose é doença sexualmente transmitida causada pelo Calymmatobacterium granulomatis. Esse pequeno bacilo intracelular Gram-negativo näo cresce nos meios de cultura bacteriológicos tradicionais. OBJETIVO - O objetivo deste trabalho foi desenvolver um método de cultura para o isolamento e crescimento dessas bactérias exigentes para novos estudos sorológicos e terapêuticos. METODOLOGIA - Inoculaçäo de lisados de tecidos infectados em monocamadas de macrófagos do peritônio de camundongo. RESULTADOS - Foram observadas, após 24 horas, bactérias intraplasmáticas com características morfológicas de C. granulomatis. Foi observada fragmentaçäo inicial dos macrófagos após 36 horas da inoculaçäo, e bactérias livres foram vistas nos meios líquidos. Quando essas bactérias foram incubadas com soros dos pacientes com donavose, elas reagiram fortemente à imunofluorescência indireta. CONCLUSÖES - Essa técnica é muito promissora e estimula as pesquisas quanto a sua otimizaçäo. Concluindo, é possível o cultivo de C. granulomatis in vitro infectando monocamada de macrófago de peritônio com lisados de tecidos infectados de donavose
Subject(s)
Animals , Mice , Calymmatobacterium/isolation & purification , Granuloma Inguinale , In Vitro TechniquesABSTRACT
Estamos presentando los resultados favorables obtenidos con la administración de azítromicina en cuatro pacientes con granuloma venereum atendidos recientemente en el centro venerológico, servicio de dermatología del Hospital Universitario de Caracas. Hubo excelente tolerancia a la droga y resolución completa, rápida y definitiva de las lesiones en todos los casos por lo que los autores se proponen continuar ensayando el antibiótico, ajustando el régimen de dosificación al tipo clínico, extensión y duración de las lesiones, incluyendo la posibilidad de dosis únicas de 1g para el tratamiento de úlceras pequeñas iniciales
Subject(s)
Humans , Male , Female , Adult , Azithromycin , Azithromycin/administration & dosage , Calymmatobacterium/cytology , Gram-Negative Bacteria/cytology , Granuloma Inguinale/diagnosis , Granuloma Inguinale/therapy , Homosexuality, MaleSubject(s)
Humans , Male , Female , Pregnancy , Acquired Immunodeficiency Syndrome , Bacterial Infections , Diagnosis, Differential , Granuloma Inguinale , Pelvic Inflammatory Disease , Penile Diseases , Pregnancy Complications , Sexually Transmitted Diseases , Calymmatobacterium , Chloramphenicol , Lincomycin , Prevalence , Risk Factors , Streptomycin , TetracyclineSubject(s)
Humans , Anti-Bacterial Agents/pharmacokinetics , Sexually Transmitted Diseases/drug therapy , Anti-Bacterial Agents/adverse effects , Azithromycin/pharmacokinetics , Calymmatobacterium/drug effects , Chlamydia trachomatis/drug effects , Clarithromycin/pharmacokinetics , Miocamycin/pharmacokinetics , Mycoplasma/drug effects , Neisseria gonorrhoeae/drug effects , Roxithromycin/pharmacokinetics , Treponema pallidum/drug effectsABSTRACT
Säo apresentados os resultados terapêuticos obtidos no tratamento de 34 pacientes portadores de donovanose, atendidos na Clínica Dermatológica da Universidade Federal de Pernambuco, Os pacientes foram tratados com tianfenicol na seguinte posologia: 2,5g sob forma de granulado, no primeiro dia e, a seguir, 500 mg de 12/12 horas até o desaparecimento das lesöes e a negativaçäo bacteriológica. Esta foi obtida em 82,4% dos pacientes a partir da segunda semana e em 100% na terceira semana de tratamento. Näo foram observados efeitos colaterais significativos ou intolerância a droga
Subject(s)
Adolescent , Adult , Humans , Male , Female , Calymmatobacterium , Sexually Transmitted Diseases/drug therapy , Thiamphenicol/therapeutic use , Clinical Trials as Topic , Thiamphenicol/metabolismABSTRACT
The relative merits of tissue smears, paraffin sections and semithin plastic embedded sections in the diagnosis of donovanosis were assessed. In three cases reported negative or doubtful for the organisms by the former two methods, semithin plastic sections provided definite diagnosis. The latter method revealed in addition the organisms in epidermis and perivascular locations. From amongst the three stains: toluidine blue, Leishman's and thionine azure II basic fuchsin, the last mentioned was found to be the method of choice for demonstrating the organisms differently from the host cells.
Subject(s)
Calymmatobacterium/ultrastructure , Granuloma Inguinale/microbiology , Histological Techniques , Humans , Staining and LabelingABSTRACT
In an ultrastructural study undertaken on donovanosis, the inflammatory response was studied along with the fine structure of causative organisms, Calymmatobacterium granulomatis. Macrophages were seen to be activated and showed presence of numerous filopodia and increase in the number of lysosomes and rough endoplasmic reticulum. Many cells showed vacuoles of varying size in the cytoplasm some of which contained the organisms. Other cells seen included plasma cells, polymorphonuclear cells and sparse lymphocytes. In one case few multinucleated giant cells and dendritic cells with long cytoplasmic processes making cell-cell contact with other inflammatory cells were seen. Such cells have not been described in donovanosis so far. The organisms showed surface structures like pili and vesicles, the role of which is yet to be clearly understood.