Non-Sexually Related Acute Genital Ulcers in 13 Pubertal Girls A Clinical and Microbiological Study

Objective: To describe the clinical and microbiological features of acute genital ulcers (AGU), which have been reported in virgin adolescents, predominantly in girls. Design: Descriptive study. We collected data on the clinical features, sexual history, blood cell count, biochemistry, microbiological workup, and 1-year follow-up. Setting: Departments of dermatology of 3 university hospitals in Paris. Patients: Thirteen immunocompetent female patients with a first flare of non-sexually transmitted AGU. Main Outcome Measures: Clinical and microbiological data, using a standardized form. Results: Mean age was 16.6 years (range, 11-19 years). Eleven patients denied previous sexual contact. A fever or flulike symptoms preceded AGU in 10 of the 13 patients (77%), with a mean delay of 3.8 days before the AGU onset (range, 0-10 days). The genital ulcers were bilateral in 10 patients. The final diagnosis was Epstein-Barr virus primary infection in 4 patients (31%) and Behcet disease in 1 patient (8%). No other infectious agents were detected in this series. Conclusions: We recommend serologic testing for Epstein-Barr virus with IgM antibodies to viral capsid antigens in non-sexually related AGU in immunocompetent patients. Further microbiological studies are required to identify other causative agents.