Genital Ulcers as Initial Manifestation of Epstein-Barr Virus Infection: Two New Cases and a Review of the Literature

Halvorsen, Jon Anders; Brevig, Trine; Aas, Torkild; Skar, Anne Grete; Slevolden, Ellen; Moi, Harald

doi:10.2340/00015555-0140

Cited by 88 publications

(68 citation statements)

References 14 publications

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“…It is not quite clear what is the clinical significance of these infections, including their role in cervical carcinogenesis. At the same time, EBV-associated genital ulcers in women have been previously reported (23,24) and although CMV is not common cause of cervicitis, it is known as an important cause of congenital infection.…”

Section: Discussionmentioning

confidence: 92%

Cervical Viral Infections among Asymptomatic Bulgarian Women

Staykova¹,

Belovska²,

Murad³

et al. 2016

Cent Eur J Public Health

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SUMMARYAim: Although sexually transmitted viral infections are significant and increasing public health concern, little is known about their prevalence among Bulgarian women. The aim of this study was to investigate cervical viral infections in asymptomatic women.Methods: The study group included 52 randomly selected asymptomatic female volunteers from Bulgarian border town Kardzhali. Cervical specimens were tested by real-time PCR for human papillomaviruses (HPV), herpes simplex virus (HSV) types 1 and 2, cytomegalovirus (CMV), Epstein-Barr virus (EBV), and human immunodeficiency virus (HIV).Results: The investigation demonstrated a high rate (61.5%) of infection with one or more viruses of uterine cervix of participating women considered at low risk. The most prevalent was HPV, found in 32.7% of all women. The genotyping of high-risk (HR) HPV positive specimens showed that HPV16 was the most prevalent HR type. HSV prevalence (30.8%) was almost as high as that of HPV and most women were HSV1 infected. 9.6% and 5.8% of all specimens were positive for EBV and CMV, respectively.Conclusions: Our results indicate that women from Kardzhali region, involved in this study, might be at risk for development of genital tract pathology, including cervical cancer, and for transmission of virus infection sexually and perinatally.

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Section: Discussionmentioning

confidence: 92%

Cervical Viral Infections among Asymptomatic Bulgarian Women

Staykova¹,

Belovska²,

Murad³

et al. 2016

Cent Eur J Public Health

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“…There have been reports of EBV-associated genital ulcers in women (2,7,14,21,25,32,53,55). This condition is underrecognized and may be incorrectly attributed to HSV infection (7,32,53).…”

Section: Discussionmentioning

confidence: 99%

Multiplex PCR Testing Detection of Higher-than-Expected Rates of Cervical Mycoplasma , Ureaplasma , and Trichomonas and Viral Agent Infections in Sexually Active Australian Women

et al. 2009

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Knowing the prevalence of potential etiologic agents of nongonococcal and nonchlamydial cervicitis is important for improving the efficacy of empirical treatments for this commonly encountered condition. We describe four multiplex PCRs (mPCRs), designated VDL05, VDL06, VDL07, and VDL09, which facilitate the detection of a wide range of agents either known to be or putatively associated with cervicitis, including cytomegalovirus (CMV), enterovirus (EV), Epstein-Barr virus (EBV), varicella-zoster virus (VZV), herpes simplex virus type 1 (HSV-1), and herpes simplex virus type 2 (HSV-2) (VDL05); Ureaplasma parvum, Ureaplasma urealyticum, Mycoplasma genitalium, and Mycoplasma hominis ( Cervicitis, an acute or chronic inflammation of the uterine cervix, is generally viewed as a consequence of infection with sexually transmissible agents. Neisseria gonorrhoeae and Chlamydia trachomatis are the most commonly reported pathogens, possibly because they are most frequently screened for. However, the etiology of most cases is undetermined and could be multifactorial in nature (11,34,35,40). Studies undertaken in other epidemiologic settings indicate significant differences in the prevalences of other cervical infectious agents (1,41,44,45,58). An underappreciation of the prevalences of and roles played by these nongonococcal and nonchlamydial agents potentially jeopardizes the effectiveness of empirical treatments for cervicitis. Unresolved cervicitis can result in ascending infection, endometritis, pelvic inflammatory disease, and salpingitis (11,23,46). Furthermore, cervicitis may enhance human immunodeficiency virus susceptibility by the disruption of mucosa, allowing increased viral replication within recruited inflammatory cells (30). The development of molecular methods, such as PCR and DNA hybridization, has allowed the detection of a range of agents whose etiologic roles in genital infections need to be further investigated, including the viruses cytomegalovirus (CMV), herpes simplex virus type 1 (HSV-1) and HSV-2 (4, 43), adenovirus (6,10,50), and the Mollicutes Ureaplasma parvum, Ureaplasma urealyticum, Mycoplasma hominis, and Mycoplasma genitalium (1,28,59). There have also been reports of genital infections caused by Epstein-Barr virus (EBV) (4, 55), varicella-zoster virus (VZV) (27), and enterovirus (EV) (24). We report here the use of four multiplex PCR (mPCR) assays, designated VDL05, VDL06, VDL07, and VDL09, based on a conventional platform, for the detection of 19 microorganisms in cervical swabs, including Treponema pallidum and C. trachomatis, Trichomonas vaginalis, group B streptococci, and five adenovirus species, in addition to those mentioned above. The assays were developed using cervical swabs from different women taken on one or more occasions during different visits to a sexual-health clinic. MATERIALS AND METHODSPatients. Cervical swabs (n ϭ 233) were taken from 175 women consecutively attending a sexual-health clinic in Sydney, Australia (between one and three visits), during 2006 and 2007 who we...

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“…Se cree que este podría actuar como citotóxico directo sobre el epitelio vulvar o como desencadenante de una reacción inmunológica sistémica. [5][6][7][8] También se han descrito casos relacionados con inmunodeficiencia de inmunoglobulina A (IgA), 14 aunque hacen falta más estudios para establecer una relación directa, ya que a la mayoría de las pacientes no se les realiza estudio de inmunidad frente a un primer episodio.…”

Section: 212unclassified

“…Es un proceso, generalmente, autolimitado y su etiología es desconocida, aunque se ha relacionado con la infección por diferentes virus. [2][3][4][5][6][7][8][9][10][11] Es una entidad subdiagnosticada 9 y, a veces, confundida con otras patologías, por lo que su diagnóstico es de exclusión.…”

Section: Introductionunclassified

Úlceras genitales de Lipschütz: reporte de un caso pediátrico

et al. 2017

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Presentación de casos clínicos RESUMENLas úlceras genitales son una patología poco frecuente en las consultas de pediatría, pero que generan gran ansiedad familiar. Las úlceras de Lipschütz son úlceras vulvares agudas, dolorosas y autolimitadas de causa desconocida. Aparecen en mujeres jóvenes que no han tenido relaciones sexuales previas o tras un período de abstinencia. Paciente de 10 años con úlceras vulvares dolorosas que, tres días antes de la aparición de las lesiones, había presentado un cuadro de deposiciones diarreicas y fiebre. Se realizó una anamnesis y exploración física detallada y se llevaron a cabo diferentes pruebas complementarias para descartar enfermedades infecciosas de origen venéreo y no venéreo, todas ellas negativas. Se indicó tratamiento sintomático, y se observó, al mes, una completa resolución del cuadro, por lo que se confirmó el diagnóstico de úlceras de Lipschütz. Palabras clave: úlceras de Lipschütz, úlceras vulvares agudas, pediatría. ABSTRACTGenital ulcers are a rare entity in pediatric consultation, but they generate great family anxiety. Lipschütz ulcers are acute, painful, and self-limiting vulvar ulcers of unknown cause. These ulcers appear in young women who have not had previous sexual intercourse or after a period of sexual abstinence. We present a 10-year-old girl with painful vulvar ulcers with a 3-day history of diarrhea and fever before the onset of the lesions. A complete anamnesis and detailed physical examination were carried out and complementary tests were performed to investigate sexually and non-sexually transmitted disease; the results were negative. Symptomatic treatment was started; at one-month follow-up a complete resolution of ulcers confirmed the diagnosis of ulcer of Lipschütz. Úlceras genitales de Lipschütz: reporte de un caso pediátrico Lipschütz ulcers: a pediatric case report INTRODUCCIÓNLa etiología de las úlceras genitales es muy diversa. La causa más frecuente es la infección por el virus herpes simple (VHS).1 Aunque, en la infancia, lo más frecuente es que no sean debidas a enfermedades de transmisión sexual, el pediatra no debe descartar esta posibilidad y realizar un correcto diagnóstico diferencial. 1,2Las úlceras de Lipschütz se caracterizan por ser úlceras genitales dolorosas que aparecen en mujeres jóvenes sin contacto sexual previo. Es un proceso, generalmente, autolimitado y su etiología es desconocida, aunque se ha relacionado con la infección por diferentes virus.2-11 Es una entidad subdiagnosticada 9 y, a veces, confundida con otras patologías, por lo que su diagnóstico es de exclusión. CASO CLÍNICOEscolar de 10 años que acudió derivada por su pediatra de Atención Primaria a Urgencias Pediátricas de un hospital terciario por presentar lesiones genitales dolorosas desde hacía cuatro días sin otra sintomatología añadida. Únicamente, refería que, tres días antes de la aparición de las lesiones, había presentado un cuadro de deposiciones diarreicas y fiebre. Consultó con su pediatra de atención primaria, quien le diagnosticó un posible ab...

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Genital Ulcers as Initial Manifestation of Epstein-Barr Virus Infection: Two New Cases and a Review of the Literature

Cited by 88 publications

References 14 publications

Cervical Viral Infections among Asymptomatic Bulgarian Women

Cervical Viral Infections among Asymptomatic Bulgarian Women

Multiplex PCR Testing Detection of Higher-than-Expected Rates of Cervical Mycoplasma , Ureaplasma , and Trichomonas and Viral Agent Infections in Sexually Active Australian Women

Úlceras genitales de Lipschütz: reporte de un caso pediátrico

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