Genital Ulceration as a Presenting Manifestation of Infectious Mononucleosis

Genital Ulcerations As Presenting Symptom of Infectious Mononucleosis

“…Direct isolation of EBV from a genital ulceration has been reported, 10 and other studies have confirmed the presence of EBV in the cervix, 11,12 lending support to this hypothesis. Several of the case reports cited in the specialty medical literature involved women who had never been sexually active, [1][2][3][4][5] similar to patient B, suggesting either autoinoculation of the genitals and/or hematogenous spread.…”

“…[1][2][3][4][5][6] This association is not well known to primary care physicians, however, and it is not described in various widely used reference texts. [7][8][9] Lack of awareness of this condition can lead to expensive, unnecessary diagnostic testing; misdiagnosis as herpes simplex virus (HSV) infection or even possible sexual abuse has serious consequences for the patient.…”

Unusual presentation of acute vulval ulceration

“…There have been associations with diseases such as para-typhoid fever 2 and EBV infection. [3][4][5][6][7][8][9] No causative factor was established in our case; stool culture was negative, EBV was not isolated in cultures, and the Paul Bunnell test was negative. In retrospect, however, testing the ulcer swabs for EBV and HSV by polymerase chain reaction would have been more diagnostic than taking cultures.…”

Lipschütz Genital Ulceration Associated with Mumps

“…In 1977, Brown and Stenchever [6] published an interesting case of vulvar ulcers in a 14-year-old virgin during an episode of mononucleosis. In the next few years, multiple cases of women with vulvar ulcers associated with tonsillitis, lymphadenopathy, mononuclear syndrome and serological profiles were published, suggesting that primary EBV infection could lead to AGU [7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23]. The report by Pelletier et al [24] from 2002 is of particular interest in this context as this group detected EBV DNA directly in the ulcers of 2 patients.…”