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Extensive Nonsexually Acquired Acute Genital Ulceration in a 2-Year-Old Girl: A Diagnostic Challenge
1Division of Pediatric Infectious Diseases, Department of Pediatrics, Kahramanmaraş Necip Fazıl City Hospital, Kahramanmaraş, Türkiye.
Abstract:
Acute nonsexually acquired genital ulceration (NSAGU) is uncommon in young children and presents a substantial diagnostic challenge because of its broad differential diagnosis. A 2-year-old girl presented with extensive bilateral vulvar ulceration and edema without systemic symptoms. Comprehensive evaluation excluded several infectious etiologies, sexually transmitted infections, and other major causes, although lesion-based herpes simplex virus testing was unavailable. The ulcers gradually resolved over 38 days following oral acyclovir, a single dose of ceftriaxone, and supportive care. Based on the clinical course and exclusion of alternative diagnoses, the presentation was considered most compatible with NSAGU, although a definitive infectious trigger could not be identified. This case highlights the importance of a broad diagnostic evaluation and cautious interpretation when definitive virologic testing is unavailable.
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