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Lipschütz ulcer and group A streptococcal tonsillitis
Sara Limão1, Ana Ventura2, Gustavo Queirós1
1Pediatric Department, Hospital Vila Franca de Xira, Vila Franca de Xira, Portugal.
BMJ Case Reports
|June 9, 2018
Summary
Lipschütz ulcers (LU), a rare condition, can be associated with Group A Streptococcus (GAS) tonsillitis. This case highlights a potential link between GAS infection and genital ulceration in pediatric patients.
Area of Science:
- Pediatric Dermatology
- Infectious Diseases
- Gynecology
Background:
- Lipschütz ulcers (LU) are defined as acute, non-sexually transmitted vulvar ulcers.
- LU are rarely reported, particularly in pediatric populations.
- Differential diagnosis for genital ulcers is broad, necessitating thorough investigation.
Observation:
- An 11-year-old girl presented with fever and a painful vulvar ulcer.
- The patient also had erythematous tonsillitis.
- Throat swab confirmed Group A Streptococcus (GAS) infection.
Findings:
- Extensive investigations, including viral DNA and serology, were negative for common infectious causes of ulcers.
- High Antistreptolysin O (ASO) titre indicated a significant streptococcal infection.
- The vulvar ulcer resolved within two weeks following amoxicillin treatment for GAS tonsillitis.
Implications:
- This case suggests a rare association between Lipschütz ulcers and Group A Streptococcus tonsillitis in children.
- Early recognition and appropriate antibiotic treatment of GAS infection may lead to rapid resolution of LU.
- Further research is warranted to elucidate the pathogenic mechanisms linking GAS to LU.
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