Lol, feeling a bit prehistoric when reading all this.
I'm totally fine with MS word + fireworks/photoshop when needed, or a few other third parties for graphs and special illustrations.
Most time goes into content anyway, "deployment" considerations are overkill in this market imho. English only is fine for most pro markets. Many manuals, if they even exist, typically lack content and information. I've seen questionable documentation trends in several companies over the last years, attempting to enforce a "Doxygenization" of good old authorship and redaction work. This doesn't work well, most humans are unlikely to enjoy the results, most time and effort being wasted. "No spectators here anyway".
IMHO the most important aspect with manuals, beside traditional structure/readability standards, is to entertain, surprise and reward. "Doxygenized" documentation workflows are straight incapable to cover these 3 aspects. For me, a good manual reads like a good book.