Pedro Mariana S, Caldas Marta, Penas Jorge, Soares Daniel
Pediatrics, Centro Hospitalar do Oeste, Unidade Caldas da Rainha, Caldas da Rainha, PRT.
Cureus. 2024 Dec 21;16(12):e76117. doi: 10.7759/cureus.76117. eCollection 2024 Dec.
An 11-month-old female patient presented to the pediatric emergency room, reporting a high fever and excessive crying. She began taking amoxicillin and clavulanic acid for acute otitis media five days prior. There was no record of trauma, suspected sexual abuse, or other medications involved. Physical examination showed a 7 mm ulcerative lesion on the left major labia and a symmetrical 5 mm violaceous lesion on the right major labia. Tests for herpesvirus, syphilis, HIV, Epstein-Barr virus, cytomegalovirus, and all returned negative results. She was discharged with symptomatic treatment. She had no fever after one day, and the ulcers resolved four weeks later. During the one-month follow-up, the complete resolution of the ulcers confirmed the diagnosis of Lipschütz ulcer, a diagnosis based on exclusion. Lipschutz ulcer is a rare, self-limited condition that does not transmit sexually. It presents with the sudden appearance of painful, necrotic ulcers on the vulva or lower vagina. This condition mainly affects sexually inactive adolescent girls or young women and is extremely uncommon in children.
一名11个月大的女性患者前往儿科急诊室,报告高烧和哭闹不止。五天前她开始服用阿莫西林和克拉维酸治疗急性中耳炎。没有创伤、疑似性虐待或其他用药记录。体格检查发现左侧大阴唇有一个7毫米的溃疡性病变,右侧大阴唇有一个对称的5毫米紫色病变。对疱疹病毒、梅毒、艾滋病毒、EB病毒、巨细胞病毒进行检测,结果均为阴性。她接受对症治疗后出院。一天后她不再发烧,溃疡四周后愈合。在为期一个月的随访中,溃疡完全愈合,证实诊断为利普许茨溃疡,该诊断基于排除法。利普许茨溃疡是一种罕见的自限性疾病,不会通过性传播。它表现为在外阴或阴道下段突然出现疼痛性坏死性溃疡。这种疾病主要影响未发生性行为的青春期女孩或年轻女性,在儿童中极为罕见。