Subject(s)
Ulcer , Vulvar Diseases , Female , Humans , Child , Ulcer/diagnosis , Vulvar Diseases/diagnosisABSTRACT
BACKGROUND: Nonsexually acquired genital ulcers have been described among girls who are prepubertal after various viral illnesses due to mucosal inflammation from an immunologic response. Until recently, nonsexually acquired genital ulcers have only been associated with viral infections. CASE: We present a case of an adolescent girl developing nonsexually acquired genital ulcers after both her first and second coronavirus disease 2019 (COVID-19) vaccine doses. Her course followed an expected timeline for severity and resolution of ulcers. CONCLUSIONS: Aphthous ulcers may arise from inflammatory effects of COVID-19 vaccination. Clinical monitoring after COVID-19 vaccination from all formulations should include assessment for nonsexually acquired genital ulcers if vaginal pain is reported.
Subject(s)
COVID-19 Vaccines , COVID-19 , Stomatitis, Aphthous , Virus Diseases , Vulvar Diseases , Adolescent , Female , Humans , COVID-19/prevention & control , COVID-19 Vaccines/adverse effects , Stomatitis, Aphthous/complications , Ulcer/diagnosis , Ulcer/etiology , Vaccination , Virus Diseases/complications , Vulvar Diseases/complicationsABSTRACT
Acute genital ulcers (AGU), known as Lipschütz ulcers, are painful vulvar ulcers typically affecting non-sexually active girls and women. AGU have been associated with viral infections, namely, Epstein-Barr virus (EBV). Here, we describe a case of AGU in the setting of SARS-CoV-2 in a non-sexually active adolescent girl hospitalised for pain control and urinary retention, who failed a course of oral corticosteroids and then improved with colchicine. Testing for herpes simplex virus, EBV and Behcet's syndrome were all negative. Testing for SARS-CoV-2 was positive. COVID-19 increases cytokines such as tumour necrosis factor alpha, which has been shown to affect endothelial cell adhesion and neutrophil chemotaxis, leading to aphthosis.
Subject(s)
COVID-19 , Epstein-Barr Virus Infections , Adolescent , Epstein-Barr Virus Infections/complications , Epstein-Barr Virus Infections/diagnosis , Female , Genitalia , Herpesvirus 4, Human , Humans , SARS-CoV-2 , Ulcer/diagnosisABSTRACT
BACKGROUND This report is of a case of vocal cord ulceration following endotracheal intubation and mechanical ventilation in a patient with severe COVID-19 pneumonia. CASE REPORT A 57-year-old woman was admitted to our hospital (Ospedale Degli Infermi, Biella, Italy) presenting with symptoms of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. Reverse transcription real-time polymerase chain reaction from a nasopharyngeal swab, authorized and validated by the World Health Organization, confirmed the diagnosis of SARS-CoV-2 infection. The patient presented with severe respiratory distress and underwent orotracheal intubation for mechanical ventilation. She was extubated after 9 days in the intensive care unit. After extubation, the patient experienced an onset of dysphonia, and was evaluated by the otolaryngologist. The videolaryngoscopy revealed the presence of an ulceration at the level of the left vocal cord. Steroids and proton pump inhibitors were administered as primary therapy for 1 week. Two weeks later, a significant improvement in the patient's voice quality was observed. A second videolaryngoscopy was performed, which displayed healing of the ulcer at the level of the left vocal fold and rapid re-epithelialization. CONCLUSIONS This report has shown that with increasing numbers of cases of severe COVID-19 pneumonia requiring endotracheal intubation and mechanical ventilation, clinical guidelines should be followed to ensure that the incidence of complications such as vocal cord ulceration are as low as possible.