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Kihara T, Kenzaka T, Hasegawa T, Uemura K, Funakoshi T. Bilateral bartholin's gland abscesses in a 4-year-old girl with vitamin a deficiency: a case report. BMC Infect Dis 2024; 24:487. [PMID: 38734601 PMCID: PMC11088118 DOI: 10.1186/s12879-024-09382-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 05/06/2024] [Indexed: 05/13/2024] Open
Abstract
BACKGROUND A Bartholin's gland abscess is one of the most common infections in women of reproductive age. Although Bartholin's gland abscesses have been reported in prepubertal children, they are rarer in prepubertal children than in adults. Herein, we report a case of bilateral Bartholin's gland abscesses in a 4-year-old girl with vitamin A deficiency. CASE PRESENTATION A 4-year-old girl diagnosed with autism spectrum disorder was admitted to the hospital for close examination and treatment because of persistent fever and malaise. The child was a marked fussy eater and was diagnosed with corneal ulceration and night blindness secondary to vitamin A deficiency. Both of the patient's labia were swollen, and a diagnosis of a bilateral Bartholin's gland abscess was made using computed tomography. Incisional drainage was performed under general anesthesia. The patient's postoperative course was uneventful, and she was discharged from the hospital on day 8 after the surgery. During hospitalization, attempts were made to correct the vitamin deficiency by adding nutritional supplements to the diet. Three months after the surgery, no recurrence of abscesses was noted. CONCLUSIONS Decreased immunocompetence and mucosal barrier function due to vitamin A deficiency is thought to be the underlying cause of Bartholin's gland abscesses. Although prepubertal Bartholin's gland abscesses have been reported, they are rare. To the best of our knowledge, no reports of bilateral Bartholin's gland abscesses potentially caused by vitamin A deficiency have been reported. When prepubertal girls present with Bartholin's gland abscesses, the presence of immunodeficiency due to vitamin or trace element deficiency should also be considered.
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Affiliation(s)
- Tomoko Kihara
- Department of Obstetrics, Hyogo Prefectural Kobe Children's Hospital, 1-6-7, Minatojimaminamimachi, Chuo-ku, Kobe, Hyogo, 650-0047, Japan.
| | - Tsuneaki Kenzaka
- Department of Internal Medicine, Hyogo Prefectural Tamba Medical Center, Tamba, Japan
- Division of Community Medicine and Career Development, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Tomohiro Hasegawa
- Department of General Medicine, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan
| | - Koutaro Uemura
- Department of Pediatric Surgery, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan
| | - Toru Funakoshi
- Department of Obstetrics, Hyogo Prefectural Kobe Children's Hospital, 1-6-7, Minatojimaminamimachi, Chuo-ku, Kobe, Hyogo, 650-0047, Japan
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Vieira-Baptista P, Grincevičienė Š, Oliveira C, Fonseca-Moutinho J, Cherey F, Stockdale CK. The International Society for the Study of Vulvovaginal Disease Vaginal Wet Mount Microscopy Guidelines: How to Perform, Applications, and Interpretation. J Low Genit Tract Dis 2021; 25:172-180. [PMID: 33631782 DOI: 10.1097/lgt.0000000000000595] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
OBJECTIVES The aims of the study were to assess the available literature concerning the indications, performance, technique, and classification of wet mount microscopy (WMM) and to establish evidence-based recommendations. METHODS Literature review from the main scientific databases was performed by the ad hoc "Vaginitis and Microbiome Committee" of the International Society for the Study of Vulvovaginal Disease. The document was approved by the executive council and membership of the International Society for the Study of Vulvovaginal Disease. RESULTS Available data are limited and usually of low level of evidence. Nevertheless, it shows that WMM is capable of reducing misdiagnosis, overtreatment, and undertreatment of vaginal conditions. It has an excellent performance for the diagnosis of bacterial vaginosis and variable performance for trichomoniasis and candidiasis. It is the gold standard for aerobic vaginitis/desquamative inflammatory vaginitis. Currently, there is no recommendation to use WMM in the screening of asymptomatic women.The use of phase contrast is recommended to improve performance and reproducibility. Sampling location, devices, and technique have an impact on the results.Available scoring and classification scores have significant limitations. CONCLUSIONS Wet mount microscopy is a point-of-care, inexpensive, and fast technique that, with practice, can be mastered by office clinicians. It should be considered a basic skill in the curricula of gynecology and obstetrics residencies. Recommendations are provided on sampling, reading, and scoring.
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Affiliation(s)
| | - Švitrigailė Grincevičienė
- Department of Biothermodynamics and Drug Design, Institute of Biotechnology, Life Sciences Center, Vilnius University, Vilnius, Lithuania
| | - Caroline Oliveira
- Maternal Child Department, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
| | - José Fonseca-Moutinho
- Health Sciences Research Centre, Faculty of Health Sciences, University of Beira Interior, Covilhã, Portugal
| | - Facundo Cherey
- Lower Genital Tract Unit, Hospital de Clínicas "José de San Martín," Buenos Aires University, Buenos Aires, Argentina
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Elkins JM, Hamid OS, Simon LV, Sheele JM. Association of Bartholin cysts and abscesses and sexually transmitted infections. Am J Emerg Med 2020; 44:323-327. [PMID: 32321682 DOI: 10.1016/j.ajem.2020.04.027] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 04/09/2020] [Accepted: 04/09/2020] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION Bartholin gland cysts or abscesses account for many gynecologic visits in the emergency department (ED). Previous smaller studies have suggested a link between Bartholin cysts/abscesses and sexually transmitted infections (STIs), but few studies have involved the ED. METHODS We retrospectively identified patients aged 18 years or older seen in 1 ED between January 2012 and March 2017 who had urinalysis and urine culture and/or were tested for gonorrhea, chlamydia, or trichomonas by nucleic acid amplification testing. Univariate and multivariate analyses were used to evaluate associations between Bartholin cysts/abscess and demographics, laboratory findings, and ED diagnoses. RESULTS Data were collected for 75,000 ED patients; 64 patients had a diagnosis of Bartholin cyst or abscess, 40 of whom were also tested for Neisseria gonorrhoeae or Chlamydia trachomatis. Ten percent of patients with a Bartholin cyst/abscess were infected with N gonorrhoeae, compared with 3% of those without a Bartholin cyst/abscess (P = .008). The rates of C trachomatis and Trichomonas vaginalis infections were 13% and 26%, respectively, among patients with a Bartholin cyst/abscess, compared with 8% and 30%, respectively, among those without a Bartholin cyst/abscess (P > .05 for both). On regression analysis, only increased urobilinogen level (β, 0.31; odds ratio, 1.36; 95% CI, 1.11-1.66; P = .003) and infection with N gonorrhoeae (β, 1.69; odds ratio, 5.40; 95% CI, 1.43-20.35; P = .01) were associated with a Bartholin cyst/abscess. CONCLUSIONS Clinicians in the ED should consider testing patients with a Bartholin cyst/abscess for gonorrhea.
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Affiliation(s)
- Justin M Elkins
- Department of Emergency, Medicine Mayo Clinic, Jacksonville, FL, United States of America
| | - Osman S Hamid
- Department of Emergency, Medicine Mayo Clinic, Jacksonville, FL, United States of America
| | - Leslie V Simon
- Department of Emergency, Medicine Mayo Clinic, Jacksonville, FL, United States of America
| | - Johnathan M Sheele
- Department of Emergency, Medicine Mayo Clinic, Jacksonville, FL, United States of America.
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Labadie JG, Guggina LM. Vulvar Majocchi granuloma and kerion formation in an immunocompetent female. Dermatol Online J 2019; 25:13030/qt4qv91478. [PMID: 31738842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 10/10/2019] [Indexed: 06/10/2023] Open
Abstract
We report a rare case of vulvar Majocchi granuloma and kerion formation secondary to Trichophyton in an immunocompetent woman. The patient responded well to oral terbinafine and a short course of oral corticosteroids with a slow taper. Resolution of deep dermatophytosis requires prompt pathogen identification and treatment to avoid scarring and hair loss. Herein, we aim to increase clinical awareness and early recognition of this atypical presentation of a Majocchi granuloma with kerion formation.
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Affiliation(s)
- Jessica G Labadie
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL.
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Abstract
Lipschütz ulcers (LU) are non-sexually related genital ulcers, rarely reported. We describe a healthy 11-year-old girl, who presented with fever and a painful vulvar ulcer associated with erythematous tonsillitis. Throat swab test for Group A Streptococcus (GAS) was positive. She was treated with amoxicillin. Further investigation was negative, including Herpes Simplex virus DNA from ulcer swab and serology for Epstein-Barr virus, cytomegalovirus and Mycoplasma pneumoniae Antistreptolysin O titre was high. The ulcer healed in 2 weeks, with no recurrence in a 1 year follow-up period. The association of LU with GAS tonsillitis is very rare.
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Affiliation(s)
- Sara Limão
- Pediatric Department, Hospital Vila Franca de Xira, Vila Franca de Xira, Portugal
| | - Ana Ventura
- Pediatric Department, Hospital de Santa Maria, Lisboa, Portugal
| | - Gustavo Queirós
- Pediatric Department, Hospital Vila Franca de Xira, Vila Franca de Xira, Portugal
| | - Florbela Cunha
- Pediatric Department, Hospital Vila Franca de Xira, Vila Franca de Xira, Portugal
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Koliou MG, Kakourou T, Richter J, Christodoulou C, Soteriades ES. Mycoplasma pneumoniae as a cause of vulvar ulcers in a non-sexually active girl: a case report. J Med Case Rep 2017; 11:187. [PMID: 28688453 PMCID: PMC5502080 DOI: 10.1186/s13256-017-1345-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Accepted: 06/02/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Non-sexually active young females very rarely develop genital ulcers. Such ulcers pose a diagnostic challenge as well as physical and emotional distress for patients and family; therefore, the search for their etiology requires exhaustive investigation. Several viruses such as Epstein-Barr virus have been associated with this entity; however, Mycoplasma pneumoniae has rarely been linked to such ulcers in the literature. We present a case of vulvar ulcers in a non-sexually active young girl during the course of pneumonia caused by Mycoplasma pneumoniae. CASE PRESENTATION A 10-year-old non-sexually active girl of cypriot origin presented at a hospital with fever, dry cough, and acute vulvar ulcers. Laboratory investigations as well as imaging studies revealed Mycoplasma pneumoniae as the cause of her pneumonia and acute vulvar ulcers. CONCLUSIONS Although a rare cause of vulvar ulcers, Mycoplasma pneumoniae should be considered in the differential diagnosis of acute vulvar ulcers coexisting with respiratory symptoms.
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Affiliation(s)
- Maria G. Koliou
- Department of Paediatrics, Archbishop Makarios III Hospital, Strovolos, Nicosia Cyprus
- University of Cyprus, School of Medicine, Nicosia, Cyprus
- Cyprus Institute of Biomedical Sciences, Nicosia, Cyprus
| | - Talia Kakourou
- First Pediatric Department, University of Athens School of Medicine, Athens, Greece
| | - Jan Richter
- Department of Molecular Virology, Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
| | - Christina Christodoulou
- Department of Molecular Virology, Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
| | - Elpidoforos S. Soteriades
- Cyprus Institute of Biomedical Sciences, Nicosia, Cyprus
- Harvard School of Public Health, Department of Environmental Health, Environmental and Occupational Medicine and Epidemiology (EOME), Boston, USA
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Abstract
Physiologic alterations of the oral and vulvovaginal mucosal surfaces result from the profound hormonal and immunologic changes of gestation. High estrogen levels are responsible for the vascular changes noted on mucosal surfaces. Gingival hyperemia and edema, gingivitis and pyogenic granuloma are the most common alterations of the oral mucosa during gestation. Physiologic changes of the vulvovaginal area are mainly of vascular nature, and include among others varicose veins. The oral and vulvovaginal mucosal surfaces can be affected by diseases that can worsen or develop in pregnancy. Oral lesions are encountered in a large spectrum of diseases including aphthosis, pemphigus vulgaris, systemic lupus, and Behçet disease. Pregnancy dermatoses such as impetigo herpetiformis and gestational pemphigoid can exceptionally affect the oral mucosa. Infections of the vulvovaginal region by Candida species, Trichomononas vaginalis, human papilloma virus, and herpes simplex virus have been associated with fetal risks. The dermatologist, obstetric medicine physician, and neonatologist should be familiar with the above physiologic changes as well as maternal/fetal risks relevant to disease affecting these mucosal surfaces during gestation.
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Affiliation(s)
- Marcia Ramos-E-Silva
- Sector of Dermatology and Post-Graduation Course, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
| | - Natalia Regina Martins
- Sector of Dermatology and Post-Graduation Course, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - George Kroumpouzos
- Department of Dermatology, Warren Alpert Medical School of Brown University, Providence, Rhode Island
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Marty E, Simon P. [Common genital infections]. Rev Med Brux 2016; 37:274-277. [PMID: 28525226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Vulvo-vaginal infections are frequently encountered by gynecologists and general practitioners. The diagnosis and the recurrence of these affections must lead to a discussion about sexually transmitted disease, notably when trichomonas vaginalis and herpetic infections are found. Even if they do not correspond to classical sexually transmitted diseases, their prevalence is increased by sexual intercourses reports and the number of partners which should also be treated. It is necessary to document the responsible germs, even in case of recurrence as more and more resistance to usual treatments are found together with the appearance of new germs like Candida glabrata.
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Affiliation(s)
- E Marty
- Service de Gynécologie-Obstétrique, Hôpital Erasme, ULB, Route de Lennik 808, Bruxelles, Belgium
| | - P Simon
- Service de Gynécologie-Obstétrique, Hôpital Erasme, ULB, Route de Lennik 808, Bruxelles, Belgium
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Shreberk-Hassidim R, Ramot Y, Maly A, Horev L, Zlotogorski A. Kerion celsi of the vulva: an unusual location. J Mycol Med 2014; 24:359-60. [PMID: 25459677 DOI: 10.1016/j.mycmed.2014.06.050] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2014] [Revised: 06/06/2014] [Accepted: 06/16/2014] [Indexed: 11/20/2022]
Affiliation(s)
- R Shreberk-Hassidim
- Department of Dermatology, Hadassah-Hebrew University Medical Center, Jerusalem 9112001, Israel
| | - Y Ramot
- Department of Dermatology, Hadassah-Hebrew University Medical Center, Jerusalem 9112001, Israel
| | - A Maly
- Department of Pathology, Hadassah-Hebrew University Medical Center, Jerusalem 9112001, Israel
| | - L Horev
- Department of Dermatology, Hadassah-Hebrew University Medical Center, Jerusalem 9112001, Israel
| | - A Zlotogorski
- Department of Dermatology, Hadassah-Hebrew University Medical Center, Jerusalem 9112001, Israel.
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Tabares-Trujillo MK, Gorbea-Chávez V, Nava-Hernández A, Rodríguez-Colorado ES. [Postpartum vulvar necrotizing fasciitis]. Ginecol Obstet Mex 2014; 82:54-63. [PMID: 24701861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
OBJECTIVE To report the case of postpartum vulvar necrotizing fasciitis diagnosis and management. CASE REPORT A 16 year old woman with a history of vaginal delivery with episiotomy uncomplicated puerperium who presents in vulvar necrotizing fasciitis rapid progression to septic shock with spread to pelvis and abdomen. RESULTS A CT scan at the level reported amount of gas vaginal labia. CONCLUSIONS An early diagnosis, multidisciplinary treatment including extensive surgical management, appropriate antibiotic coverage and intensive care unit, are factors that improve the prognosis and reduce mortality.
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Carey E, Zedek D, Lewis J, Zolnoun D. Superimposed methicillin-resistant Staphylococcus aureus infection of vulvar eczematous dermatitis: a case report. J Reprod Med 2013; 58:261-263. [PMID: 23763013 PMCID: PMC4085041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
BACKGROUND Vulvar eczematous dermatitis predisposes patients to superimposed infections, which may result in late diagnosis and architectural destruction. Methicillin-resistant Staphylococcus aureus (MRSA) infection is on the rise in genitalia and lower extremities. CASE A 44-year-old woman presented with recurrent vulvar lesions and pain. A diagnosis of MRSA in the setting of eczema was achieved with concomitant use of photography and dermatopathologic review. Antibiotics were tailored to the resistant infection and preventative moisturization therapy was utilized. CONCLUSION Awareness of dermatologic conditions affecting the vulva is principal in routine gynecologic care. Barrier protection of eczematous vulvar skin may prevent superficial infections. The regular use of photographic documentation and dermatopathology may decrease time to diagnosis with infrequent or rare conditions.
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Affiliation(s)
- Erin Carey
- Pelvic Pain Research Unit, Division of Advanced Laparoscopy and Pelvic Pain, Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, 4010 Old Clinic Building, CB #7570, Chapel Hill, NC 27599, USA.
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Kallini JR, Cohen PR. Perianal and periumbilical dermatitis: Report of a woman with group G streptococcal infection and review of perianal and periumbilical dermatoses. Dermatol Online J 2013; 19:3. [PMID: 24021363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2013] [Accepted: 04/14/2013] [Indexed: 06/02/2023] Open
Abstract
PURPOSE We describe a woman with perianal and periumbilical dermatitis secondary to group G Streptococcus, summarize the salient features of this condition, and review other cutaneous conditions that clinically mimic streptococcal dermatitis of the umbilicus. BACKGROUND Periumbilical and perianal streptococcal dermatitis are conditions that commonly occur in children and usually result from beta-hemolytic group A Streptococcus. Rarely, non-group A streptococcal and staphylococcal infections have been reported in adults. MATERIALS AND METHODS A 31-year-old woman developed perianal and periumbilical group G streptococcal dermatitis. Symptoms were present for six months and were refractory to clotrimazole 1 percent and betamethasone dipropionate 0.05 percent cream. RESULTS The etiology of perianal and periumbilical dermatitis is unclear, but is perhaps explained by virulence of previously asymptomatic colonized bacteria. Perianal streptococcal dermatitis is more common in children. A number of adult infections have been reported, most of which were secondary to group A beta-hemolytic Streptococcus. Men are more often affected than women. Group G Streptococcus is rarely the infective etiology of perianal streptococcal dermatitis. This condition presents as a superficial well demarcated erythematous patch on clinical examination. Diagnosis is ascertained by diagnostic swabs and serological tests: antistreptolysin O (ASO) or anti-DNase titer. Treatments include oral amoxicillin, penicillin, erythromycin, and mupirocin ointment. CONCLUSIONS Our patient expands on the clinical presentation typical of streptococcal dermatitis. We describe a rare occurrence of an adult woman infected with non-group A Streptococcus. Several conditions can mimic the presentation of perianal streptococcal dermatitis. Although rare, group G Streptococcus should be considered in the setting of virulent infections usually attributed to group A species. Streptococcal dermatitis can be added to the list of conditions affecting the umbilicus.
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Colón M, Romaguera J, Mendez K, Vilchez D, Navas EJ, Perez J. Mucormycosis of the vulva in an immunocompromised pediatric patient. Bol Asoc Med P R 2013; 105:65-67. [PMID: 23882994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Primary cutaneous mucormycosis is very unusual and rarely reported in the literature. The diagnosis is difficult and may mimic several infectious and immunologic diseases. We report a case of vulvar mucormycosis in a pediatric patient with end stage renal disease. A female on her first decade of life presented with a small scar on the right labia majora that in matters of weeks progressed aggressively, ulcerated, extended to the contralateral labia and invaded the entir vulvar region. Subsequent surgical debridement was undertaken. Pathology revealed Mucor species with progressive tissue necrosis. The patient was successfully trea ed with systemic antifungal, wide debridement of the affected area, hyperbaric oxygen therapy and surgical reconstruction of the area
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Affiliation(s)
- Malieri Colón
- Department of Obstetrics and Gynecology, UPR School of Medicine, Medical Sciences Campus, San Juan, Puerto Rico
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Nanjappa V, Suchismitha R, Devaraj HS, Shah MB, Anan A, Rahim SN. Vulval tuberculosis - an unusual presentation of disseminated tuberculosis. J Assoc Physicians India 2012; 60:49-52. [PMID: 23781671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Extrapulmonary involvement can occur in isolation or along with a pulmonary focus as in the case of patients with disseminated tuberculosis. Vulval TB is very rare and the presentation can be quite variable, and may be misdiagnosed as sexually transmitted disease. We herein report a young lady with disseminated TB presenting as Vulval TB.
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MESH Headings
- Adult
- Antitubercular Agents/therapeutic use
- Female
- Humans
- Tuberculosis, Female Genital/complications
- Tuberculosis, Female Genital/diagnosis
- Tuberculosis, Female Genital/drug therapy
- Tuberculosis, Pleural/complications
- Tuberculosis, Pleural/drug therapy
- Tuberculosis, Pulmonary/complications
- Tuberculosis, Pulmonary/drug therapy
- Tuberculosis, Spinal/complications
- Tuberculosis, Spinal/drug therapy
- Tuberculosis, Spinal/surgery
- Vulvar Diseases/drug therapy
- Vulvar Diseases/microbiology
- Young Adult
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Affiliation(s)
- Veena Nanjappa
- Department of Medicine, JSS Medical College and Hospital, Mysore
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Udupa K, Ganesan P, Majhi U, Rajendranath R, Sagar TG. Favorable outcome in a patient with vulvar mucormycosis during acute myeloid leukemia induction with medical management alone. Hematol Oncol Stem Cell Ther 2012; 5:125-6. [PMID: 22828378 DOI: 10.5144/1658-3876.2012.125a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Bodamyali P, Akay BN, Kundakçi N, Erdem C, Okçu-Heper A, Akyol A. Infantile lepromatous leprosy with vulvar localization. Turk J Pediatr 2011; 53:213-215. [PMID: 21853663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Reports of leprosy during the first year of life are uncommon. In the early diagnosis, the spectrum for most of the children is reported to be largely confined to tuberculoid (TT), borderline tuberculoid (BT), mid-borderline (BB), and indeterminate forms of leprosy. We report a one-year-old female infant presenting numerous erythematous papules on her labium majus and pale flat macules on her chin and right cheek for about four months. A biopsy revealed changes typical for lepromatous leprosy (LL). Infantile leprosy and the route of transmission are discussed here.
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Matula V, Kestránek J, Buchta V, Brod'ák M, Spacek J. [Possibilities of diagnostics yeasts in gynecologist patients]. Ceska Gynekol 2010; 75:547-552. [PMID: 27534013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Problem of mycoses in gynecology is considered very frequent and yeasts are traditionally described as most common cause of vulvovaginal disorders. While acute disorders can be promptly cured in most cases, there is a group of women suffering from those repeatedly. Following article refers to a group of patients in long-term follow-up and shows realistic possibilities of diagnostics, available to out-patient gynecologist. Preliminary results of our pilot project do not confirm yeasts have to be the primary etiologic factor, nevertheless it is logical to be in search of them in these patients.
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Balistreri M, Hagedorn J, Stitely ML. Vulvar abscess: a retrospective review. W V Med J 2010; 106:24-26. [PMID: 21932487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Vulvar abscesses can progress to cause significant illness requiring disfiguring surgical debridement, broad spectrum antibiotics, and require hospitalization. A retrospective review of de-identified charts of 13 patients admitted for inpatient care for vulvar abscesses from 2004-2009 at West Virginia University Hospitals was conducted. Risk factors for vulvar abscess in these patients included obesity and diabetes. Body mass index (BMI) is directly proportionate to the size of the abscess and increased risk of intensive care unit admission. Most patients did not seek medical care prior to hospital admission. Polymicrobial infections were common, and methicillin resistant Staphylococcus aureus was seen in two cases. The presence of multiple risk factors increased the length of hospitalization. Clinicians should be aware of these risk factors and initiate aggressive therapy for patients with elevated BMI or multiple risk factors.
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Affiliation(s)
- Michael Balistreri
- West Virginia University School of Medicine, Department of Obstetrics and Gynecology, Morgantown, WV, USA
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Mebazaa A, Abdelmalek R, Azzouz H, El Euch D, Rouhou RC, Trojjet S, Kchir N, Mokni M, Zitouna M, Ben Osman A. [Vulval tuberculosis in an immunocompetent female]. Tunis Med 2010; 88:770-771. [PMID: 20890832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
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Buppasiri P, Temtanakitpaisan T, Somboonporn W. Tuberculosis at vulva and vagina. J Med Assoc Thai 2010; 93:613-615. [PMID: 20524449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
A 60- year-old woman, gravid 4, para 4-0-0-4 was admitted to the Department of Obstetrics and Gynecology, Khon Kaen University due to chronic extensive painful genital ulcer. She was treated by antiviral and antifungal regimens but the ulcer persisted. After acid fast bacilli was found on tissue biopsy, a standard 6- month course of antituberculosis was started. One month after treatment, the ulcer was completely cured.
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Affiliation(s)
- Pranom Buppasiri
- Department of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
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22
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Sahlgren HM, Sjöberg I, Nylander E. [Genital itching]. Lakartidningen 2010; 107:596-599. [PMID: 20387759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
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23
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Kilpatrick CC, Alagkiozidis I, Orejuela FJ, Chohan L, Hollier LM. Factors complicating surgical management of the vulvar abscess. J Reprod Med 2010; 55:139-142. [PMID: 20506675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
OBJECTIVE To delineate risk factors and demographics in those patients with vulvar abscess that required surgical intervention, identify the most common bacterial isolate present at the time of surgery and comment on the progression to necrotizing fasciitis and the need for reoperation. STUDY DESIGN Retrospective chart review. RESULTS A total of 47 vulvar abscesses with cellulitis were managed surgically. The most common isolate was methicillin-resistant Staphylococcus aureus (MRSA), which comprised 43% of the total. The median length of stay was 4 days (1-66), and 17% had stays >7 days. Diabetes was significantly related to hospitalization >7 days (38% vs. 6%, p<0.01), reoperation (25% vs. 3%, p=0.02) and progression to necrotizing fasciitis (19% vs. 0%, p=0.01). CONCLUSION When treating abscess of the vulva with cellulitis, antibiotic coverage of MRSA should be undertaken. Inpatient management with aggressive treatment for abscess of the vulva in those patients with concomitant diabetes is recommended.
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Affiliation(s)
- Charlie C Kilpatrick
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Texas-Houston Medical School, LBJ Hospital, 5656 Kelley Street, Houston, TX 77026, USA.
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Nakayama J, Busse R. An analysis of vulvar necrotizing fasciitis in the unique and ethnically diverse Hawaiian population. Hawaii Med J 2010; 69:13-16. [PMID: 20222491 PMCID: PMC3104625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Vulvar necrotizing fasciitis is a surgical emergency with a high rate of morbidity and mortality. Our case series adds seven patients to the literature and presents the first group that is predominantly of Pacific-Islander origin. This study not only confirms traditional risk factors such as diabetes mellitus, obesity and hypertension but investigates ethnicity and socioeconomic status as risk factors. Also presented is a case of recurrent necrotizing fasciitis initially involving the vulva, then the back. In any patient for which there is suspicion of vulvar necrotizing fasciitis, surgical diagnosis remains the gold standard and facilitates rapid debridement of all necrotic tissues. Aggressive surgical debridement with broad spectrum antibiotic coverage is required to minimize mortality.
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25
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Nguyen RHN, Swanson D, Harlow BL. Urogenital infections in relation to the occurrence of vulvodynia. J Reprod Med 2009; 54:385-392. [PMID: 19639929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
OBJECTIVE To determine whether antecedent urogenital infections and their frequency are associated with the development of vulvodynia. STUDY DESIGN Data were obtained from a case-control study of 191 case and 171 control women in the Boston area from 2000 to 2005. Using questionnaire data, we examined self-reported urogenital infections occurring before onset of vulvar pain (cases) and reference age (controls), using unconditional logistic regression accounting for matched variables (current age and residence). RESULTS Analysis was restricted to women reporting intercourse before first vulvar pain (cases) or reference age (controls). After adjusting for race, age at first intercourse, coital frequency and number of sex partners, a history of genital warts (adjusted odds ratio [OR] = 3.4, 95% CI 1.3-8.8), trichomoniasis (OR = 5.7, 95% CI 1.1-29, urinary tract infection (OR = 2.0, 95% CI 1.3-3.1) or yeast infection (OR = 2.1, 95% CI 1.3-3.3) were associated with increased estimated risk for vulvodynia. With an increasing number of types of antecedent infections (1, 2 or 3+), ORs = 1.3, 2.6 or 8.3, respectively, were observed. CONCLUSION Our data suggest that diverse urogenital infections may precede onset of vulvodynia, with multiple assaults significantly compounding risk. However, prospective studies documenting urogenital infections and treatment are warranted.
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Affiliation(s)
- Ruby H N Nguyen
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 South 2nd Street, Suite 300, Minneapolis, MN 55454, USA.
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26
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Okoduwa C, Heller DS. Vulvar diseases of the tropics: a review. J Reprod Med 2009; 54:61-66. [PMID: 19301568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
With the increasing immigrant population in the United States, it is imperative for clinicians in the United States to become versed in tropical vulvar conditions uncommon to indigenous members of developed nations that may present to their practice. Travelers to tropical areas may also contract diseases that occur in these areas, which may manifest as a vulvar condition and mimic a sexually transmitted disease. A brief review is presented.
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Affiliation(s)
- Cynthia Okoduwa
- Department of Pathology and Laboratory Medicine, University of Medicine and Dentistry-New Jersey, New Jersey Medical School, Newark, New Jersey 07101, USA
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27
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Jiang L, Wang JL, Zhu L. [Summary of the national seminar on diagnosis and treatment of female vulvar-vaginal diseases]. Zhonghua Fu Chan Ke Za Zhi 2008; 43:483-485. [PMID: 19080507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
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Abstract
Background. We present a case of Actinomyces israelii
causing vulvar mass suspicious for malignancy in a postmenopausal
woman. Case. A 60 year-old woman presented due to a firm,
nonmobile, 10 cm vulvar mass, which had been rapidly
enlarging for 5 months. The mass was painful, with localized
pruritus and sinus tracts oozing of serosanguinous fluid. Biopsy
and cultures revealed a ruptured epidermal inclusion cyst
containing granulation tissue and Actinomyces israelii.
Conclusion. Actinomyces israelii may produce vulvar
lesions that are suspicious for malignancy. Thus, biopsies and
cultures are both mandatory while evaluating vulvar masses
suspicious for malignancy.
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Affiliation(s)
- Jennifer Y. McElroy
- Department of Obstetrics and Gynecology, Rush
University Medical Center, Chicago, IL 60612, USA
- *Jennifer Y. McElroy:
| | - Marsha E. Gorens
- Department of Obstetrics and Gynecology, Rush
University Medical Center, Chicago, IL 60612, USA
| | - Lisa N. Jackson
- Department of Obstetrics and Gynecology, Rush
University Medical Center, Chicago, IL 60612, USA
| | - Danielle Stigger
- Department of Obstetrics and Gynecology, Rush
University Medical Center, Chicago, IL 60612, USA
| | - Teresa Becker
- Department of Obstetrics and Gynecology, Rush
University Medical Center, Chicago, IL 60612, USA
| | - Eyal Sheiner
- Department of Obstetrics and Gynecology, Rush
University Medical Center, Chicago, IL 60612, USA
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29
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Swaminathan S, Kelley P, Ahern M, Gordon D. Acute cytomegalovirus infection presenting with severe vulvar swelling. Int J Gynaecol Obstet 2007; 99:133-4. [PMID: 17612541 DOI: 10.1016/j.ijgo.2007.04.035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2007] [Revised: 04/24/2007] [Accepted: 04/24/2007] [Indexed: 11/28/2022]
Affiliation(s)
- S Swaminathan
- Department of Immunology, Allergy and Arthritis, Flinders Medical Centre, Adelaide, Australia
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30
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Affiliation(s)
- Marc Tebruegge
- Department of Paediatrics, Southend University Hospital, Southend-on-Sea, UK.
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31
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Hills RL. Cytolytic vaginosis and lactobacillosis. Consider these conditions with all vaginosis symptoms. Adv Nurse Pract 2007; 15:45-48. [PMID: 19998926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Affiliation(s)
- Robin L Hills
- Virginia Commonwealth University School of Nursing, Richmond, USA
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32
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Pagano R. Value of colposcopy in the diagnosis of candidiasis in patients with vulvodynia. J Reprod Med 2007; 52:31-4. [PMID: 17286065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
OBJECTIVE To evaluate the value of colposcopy in the diagnosis of chronic vulvar candidiasis in patients presenting with vulvodynia. STUDY DESIGN A prospective study of 460 patients presenting with vulvodynia over a 24-month period was undertaken. All patients underwent colposcopy of the vulva, which was regarded as positive if acetowhite lesions with central clearing with or without petechiae were present. Vulvar skin scrapings were taken for Candida culture on all patients. Those patients with positive colposcopic findings were treated with long-term oral antimycotic therapy irrespective of laboratory findings. RESULTS Patients with positive colposcopic findings and positive cultures had a 93% rate of improvement in symptoms. Those with positive colposcopic findings and negative cultures also had a 60% rate of improvement. Thus, the overall improvement rate in patients with positive colposcopic findings (irrespective of culture results) was 76%. When colposcopy findings were negative, Candida cultures were also negative in 92% of patients. CONCLUSION Colposcopy of the vulva can be a valuable triage tool in the assessment of patients with vulvodynia by detecting changes that are highly suspicious for the presence of chronic vulvar candidiasis.
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Affiliation(s)
- Ross Pagano
- Vulvar Disorders Clinic, Royal Women's Hospital, Carlton, Melbourne, Australia.
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33
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Öztoprak N, Bayar Ü, Çelebi G, Basaran M, Cömert F. Eikenella corrodens, cause of a vulvar abscess in a diabetic adult. Infect Dis Obstet Gynecol 2006; 2009:63565. [PMID: 17485819 PMCID: PMC1791056 DOI: 10.1155/2007/63565] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2006] [Revised: 10/12/2006] [Accepted: 10/20/2006] [Indexed: 11/17/2022] Open
Abstract
We report a case of Eikenella corrodens causing vulvar abscess in a diabetic patient. Eikenella corrodens is a slow growing, nonmotile, facultative anaerobic, Gram-negative bacillus which is commensal of the oral cavity, intestinal and genital tracts. The most common clinical sources of this organism are human bite wounds, head and neck infections and respiratory tract infections. In our knowledge, the presented case is the first report of Eikenella corrodens causing vulvar abscess in a diabetic patient.
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Affiliation(s)
- Nefise Öztoprak
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Zonguldak Karaelmas University, 67600 Zonguldak, Turkey
- *Nefise Öztoprak:
| | - Ülkü Bayar
- Department of Obstetrics and Gynecology, Faculty of Medicine, Zonguldak Karaelmas University, 67600 Zonguldak, Turkey
| | - Güven Çelebi
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Zonguldak Karaelmas University, 67600 Zonguldak, Turkey
| | - Mustafa Basaran
- Department of Obstetrics and Gynecology, Faculty of Medicine, Zonguldak Karaelmas University, 67600 Zonguldak, Turkey
| | - Füsun Cömert
- Department of Microbiology and Clinical Microbiology, Faculty of Medicine, Zonguldak Karaelmas University, 67600 Zonguldak, Turkey
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Gallo A, Bettoni G, Trezzi G, Lalinga V, Frigerio L. Primary vulvar nocardiosis. Obstet Gynecol 2006; 108:728-30. [PMID: 17018480 DOI: 10.1097/01.aog.0000188068.10174.90] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Nocardiosis is an uncommon disease, and the primary skin infection is usually at the site of a recent injury. Nocardia is a saprophytic bacterium of the soil belonging to the order Actinomycetales. CASE A 68-year-old woman presented with a painful, hard, dark reddish lesion located in the right hemivulva. She had been treated by radiotherapy for a vulvar leiomyosarcoma arising from the left Bartholin gland at the age of 45. Pathology results demonstrated nocardial infection, initially advanced despite antibiotic therapy. The necrosis extended to and involved the ischiopubic bone, requiring extensive surgical treatment. We performed a radical vulvectomy with partial pubic bone excision to remove the necrotic tissue. A transverse gracilis-myocutaneous free flap was used for vulvar reconstruction. Wound necrosis recurrence required a rectus abdominis myocutaneous flap reconstruction, with an excellent final result. CONCLUSION This is the first report of primary vulvar nocardiosis. This infection may simulate advanced vulvar carcinoma requiring extensive surgical treatment.
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Affiliation(s)
- Angelo Gallo
- Division of Gynecology and Obstetrics, Ospedali Riuniti di Bergamo, Milano Bicocca University, Bergamo, Italy
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35
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Chêne G, Tardieu AS, Nohuz E, Rabischong B, Favard A, Mage G. [Postoperative complications of Bartholin's duct abscess. About two cases]. ACTA ACUST UNITED AC 2006; 34:615-8. [PMID: 16777462 DOI: 10.1016/j.gyobfe.2006.05.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2005] [Accepted: 05/02/2006] [Indexed: 10/24/2022]
Abstract
Bartholinitis is the most common infectious vulvar disease and develops in approximately 2% of all women. The choice concerning treatment may be uneasy between medical or surgical modalities, and we have to be cautious because of the risk of severe complications associated with the procedure. We report two cases: one case of sepsis and the other one of bacterial cellulitis after Bartholin's duct abscess marsupialization. In the light of epidemiological and bacteriological date referring to Bartholinitis, we recommend a safe and effective management (particularly the use of broad-spectrum antibiotics) that we will describe.
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Affiliation(s)
- G Chêne
- Fédération de gynécologie-obstétrique, CHU, polyclinique de l'Hôtel-Dieu, boulevard Léon-Malfreyt, 63058 Clermont-Ferrand cedex 01, France.
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36
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Mendilcioglu I. Recurrent periclitoral abscess: treatment of a rare cause of vulvar pain. Eur J Obstet Gynecol Reprod Biol 2006; 131:101-102. [PMID: 16735087 DOI: 10.1016/j.ejogrb.2005.11.051] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2005] [Revised: 10/06/2005] [Accepted: 11/29/2005] [Indexed: 10/24/2022]
Affiliation(s)
- Inanc Mendilcioglu
- Akdeniz University, School of Medicine, Department of Obstetrics and Gynecology, Dumlupinar Bulvari, Arapsuyu, Antalya 07070, Turkey.
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37
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Kdous M, Hachicha R, Iraqui Y, Jacob D, Piquet PM, Truc JB. Fasciite nécrosante du périnée secondaire à un traitement chirurgical d'un abcès de la glande de Bartholin. ACTA ACUST UNITED AC 2005; 33:887-90. [PMID: 16243570 DOI: 10.1016/j.gyobfe.2005.06.022] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2005] [Accepted: 06/27/2005] [Indexed: 11/27/2022]
Abstract
Necrotizing fasciitis of the perineum is a rare but of fast evolution, and potentially fatal infectious disease process. It is characterized by progressive inflammation and extensive necrosis of subcutaneous tissue involving the fascia and other adjacent tissues. This infection may be idiopathic or secondary to local trauma or pelvic surgery. Its mortality rate is 20%. We report a case of necrotzing fasciitis of the perineum in a 34-year-old woman following incision and drainage of Bartholin's gland abscess. Streptococcus A, Proteus mirabilis, Escherichia coli, and Candida albicans were isolated. Intravenous broad spectrum antibiotic therapy was promptly instituted. Concurrent surgical debridement of all necrotic areas was required. Post debridement therapy required a long period of dressing changes until cicatrisation. Necrotizing fasciitis of the perineum is a surgical emergency. Early diagnosis and prompt aggressive debridement are the keys to successful management.
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Affiliation(s)
- M Kdous
- Service de gynécologie-obstétrique, hôpital Lariboisière, 2, rue Ambroise-Paré, 75010 Paris, France.
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38
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Abstract
We report a case of Majocchi's granuloma caused by Trichophyton mentagrophytes on the vulva in a 23-year-old girl who had used topical steroids for many years. Her dog was a source of the infection.
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Affiliation(s)
- S E Chang
- Department of Dermatology, Asan Medical Center, College of Medicine, University of Ulsan, Songpa-gu, Seoul, Korea.
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39
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Abstract
This study was conducted to determine the current epidemiology concerning the causative organisms for Bartholin's gland abscess in Japan. Microbiological examination of 224 cases showed positive results in 219 cases and negative results in 5 cases. Of all of the bacterial isolates, 307 and 118 were aerobes and anaerobes, respectively. The most frequently isolated bacterium was Escherichia coli. Of the anaerobes, the most frequently isolated organism was Bacteroides species, followed by Prevotella species. The organisms related to respiratory infectious diseases, such as Streptococcus pneumoniae and Haemophilus influenzae, including resistant bacteria, were sometimes involved between 2000 and 2004.
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Affiliation(s)
- Kaori Tanaka
- Division of Anaerobe Research, Life Science Research Center, Gifu University, Department of Obstetrics and Gynecology, Gifu University Hospital, Department of Obstetrics and Gynecology, Izumi Ladies Clinic, Department of Obstetrics and Gynecology, Gifu Municipal Hospital, Gifu City, Gifu College of Medical Technology, Seki City, Japan
| | - Hiroshige Mikamo
- Division of Anaerobe Research, Life Science Research Center, Gifu University, Department of Obstetrics and Gynecology, Gifu University Hospital, Department of Obstetrics and Gynecology, Izumi Ladies Clinic, Department of Obstetrics and Gynecology, Gifu Municipal Hospital, Gifu City, Gifu College of Medical Technology, Seki City, Japan
- Corresponding author. Mailing address: Division of Anaerobe Research, Life Science Research Center, Gifu University 1-1 Yanagido, Gifu City, Gifu 501-1194, Japan. Phone: 81 58 230 6552. Fax: 81 58 230 6551. E-mail:
| | - Mochiyoshi Ninomiya
- Division of Anaerobe Research, Life Science Research Center, Gifu University, Department of Obstetrics and Gynecology, Gifu University Hospital, Department of Obstetrics and Gynecology, Izumi Ladies Clinic, Department of Obstetrics and Gynecology, Gifu Municipal Hospital, Gifu City, Gifu College of Medical Technology, Seki City, Japan
| | - Teruhiko Tamaya
- Division of Anaerobe Research, Life Science Research Center, Gifu University, Department of Obstetrics and Gynecology, Gifu University Hospital, Department of Obstetrics and Gynecology, Izumi Ladies Clinic, Department of Obstetrics and Gynecology, Gifu Municipal Hospital, Gifu City, Gifu College of Medical Technology, Seki City, Japan
| | - Koji Izumi
- Division of Anaerobe Research, Life Science Research Center, Gifu University, Department of Obstetrics and Gynecology, Gifu University Hospital, Department of Obstetrics and Gynecology, Izumi Ladies Clinic, Department of Obstetrics and Gynecology, Gifu Municipal Hospital, Gifu City, Gifu College of Medical Technology, Seki City, Japan
| | - Kunihiko Ito
- Division of Anaerobe Research, Life Science Research Center, Gifu University, Department of Obstetrics and Gynecology, Gifu University Hospital, Department of Obstetrics and Gynecology, Izumi Ladies Clinic, Department of Obstetrics and Gynecology, Gifu Municipal Hospital, Gifu City, Gifu College of Medical Technology, Seki City, Japan
| | - Kazukiyo Yamaoka
- Division of Anaerobe Research, Life Science Research Center, Gifu University, Department of Obstetrics and Gynecology, Gifu University Hospital, Department of Obstetrics and Gynecology, Izumi Ladies Clinic, Department of Obstetrics and Gynecology, Gifu Municipal Hospital, Gifu City, Gifu College of Medical Technology, Seki City, Japan
| | - Kunitomo Watanabe
- Division of Anaerobe Research, Life Science Research Center, Gifu University, Department of Obstetrics and Gynecology, Gifu University Hospital, Department of Obstetrics and Gynecology, Izumi Ladies Clinic, Department of Obstetrics and Gynecology, Gifu Municipal Hospital, Gifu City, Gifu College of Medical Technology, Seki City, Japan
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40
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Mikamo H, Tamaya T, Tanaka K, Watanabe K. [Two cases of Bartholin's gland abscesses caused by Streptococcus pneumoniae and Haemophilus influenzae]. Jpn J Antibiot 2005; 58:375-81. [PMID: 16276738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Most of Bartholin's gland abscesses have been thought to be caused by microorganisms found in opportunistic infections. However, we have encountered two very interesting cases of Bartholin's gland abscesses caused by Streptococcus pneumoniae and Haemophilus influenzae, two major pathogens of respiratory tract infections. In the first case, since abscess formation was not observed due to disintegration, cefdinir (CFDN), 300 mg/day, t.i.d. for 5 days was administered. The treatment improved clinical symptoms, but relapse occurred 3 days after the administration was discontinued. Microbiological examination of pus revealed the presence of Streptococcus pneumoniae and Finegoldia magna, and it also showed that the isolated S. pneumoniae was penicillin-resistant S. pneumoniae (PRSP). After an incision and drainage of abscess, cefteram pivoxil (CFTM-PI), 300 mg/day t.i.d. for 7 days, was administered, and the cure was confirmed. In the second case, after an incision and drainage of Bartholin's gland abscess, amoxicillin (AMPC), 750 mg/day, t.i.d. for 5 days, was administered. The treatment improved clinical symptoms temporarily. However, the symptoms deteriorated 7 days after the operation, and the patient was diagnosed with relapse. Microbiological examination of pus revealed the presence of Haemophilus influenzae and Peptostreptococcus anaerobius, and it also showed that the isolated H. influenzae was beta-lactamase-nonproducing ampicillin-resistant H. influenzae (BLNAR). After performing additional incision and drainage of abscess again, CFTM-PI, 300 mg/day, t.i.d. for 7 days, was administered, and the cure was confirmed. In addition, the analysis of these two cases using PK/PD theory revealed that the time above MIC reached 100% with administration of CFTM-PI 300mg, t.i.d. suggesting that the dosage is sufficient for treating these infections. There are other cases of external genitalia infections caused by microorganisms usually associated with respiratory tract infections like cases that we are reporting here. Therefore, it is necessary to consider a possible infection by drug-resistant bacteria even for a case of external genitalia infection. In addition, it was thought that adjusting dosage and method for administration of antibacterial agents based on PK/PD theory would help to rovide efficient treatment.
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Affiliation(s)
- Hiroshige Mikamo
- Division of Anaerobe Research, Life Science Research Center, Gifu University
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41
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Affiliation(s)
- O Faye
- Service Dermatologie CNAM, BP 251, Bamako, Mali.
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42
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Shaw C, Mason M, Scoular A. Group B streptococcus carriage and vulvovaginal symptoms: causal or casual? A case-control study in a GUM clinic population. Sex Transm Infect 2003; 79:246-8. [PMID: 12794214 PMCID: PMC1744671 DOI: 10.1136/sti.79.3.246] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES The isolation of group B streptococcus (GBS) on routine swabs taken from genitourinary medicine (GUM) clinic attendees is a common finding. The relation of GBS to vulvovaginal symptoms is unclear, creating confusion about management. This case-control study tested the hypothesis that detection of GBS on routine clinical specimens is not causally related to vulvovaginal symptoms in female GUM clinic attendees. METHODS Data were collected on all female GUM clinic attendees who had GBS isolated from anogenital swabs between July 1999 and July 2001. Controls were randomly selected from all new and rebooking female GUM clinic attendees. Controls were group matched for age with cases and were included only if a sexual health screen was performed and the results of this were available. RESULTS 118 cases and 308 controls were identified during the study period. There was no significant difference between cases and controls in patient demographic or behavioural characteristics, the presence of genital co-infection, or vulvovaginal symptoms. There was no relation between symptoms and quantitative growth of GBS reported by the laboratory in either cervical or urethral swabs. Only nine cases had high vaginal swabs taken, in whom there was a significant association between a heavy growth of GBS and vulvovaginal symptoms (p=0.008). CONCLUSION The isolation of GBS from routinely collected genital swabs in female attendees of a GUM clinic is not causally related to vulvovaginal symptoms. We recommend that patients should receive this advice and should not be treated with antibiotic therapy for this indication.
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Affiliation(s)
- C Shaw
- Department of Genitourinary Medicine, The Sandyford Initiative, 2-6 Sandyford Place, Sauchiehall Street, Glasgow G3 7NB, UK
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43
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Abstract
INTRODUCTION Non-tropical pyomyositis is a commonly reported infection in immunodeficient patients' muscle but is rare without immunodeficiency. CASE DESCRIPTION We report the case of a 40-year-old woman admitted in the physical medicine and rehabilitation department for a motor and sensory loss of the lower limb; this disorder appeared after rhabdomyolysis due to prolonged lying position (suicide attempt). The initial diagnosis of sciatic nerve compression was not consistent with motor loss of adductor muscles. Clinical examination revealed soft tissue swelling in the proximal part of her lower limb. CT scan displayed pyomyositis of the thigh (hip adductors and gluteus medius), which was successfully treated by surgical incision and drainage in combination with antibiotherapy. CONCLUSION Non-tropical pyomyositis is rarely described without immunodeficiency but this diagnosis should be borne in mind when previous muscle trauma is associated to leukocytosis. Computed tomography and MRI are the tests of choice to confirm the diagnosis of pyomyositis and to differentiate it from other entities.
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Affiliation(s)
- A Poujois
- Service de médecine physique et de réadaptation, hôpital de la Salpêtrière, 47, boulevard de l'Hôpital, 75675 cedex 13, Paris, France
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44
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Abstract
AIMS We investigated the spectrum of yeasts isolated, and compared the epidemiological and laboratory characteristics of women carrying vulvovaginal Candida albicans with those carrying yeasts other than C. albicans. METHOD Between April and June 2001, 5802 consecutively received genital swabs from women were plated onto Candida ID chromogenic media (BioMerieux). Blue colonies were reported as C. albicans; all other colonies (white and pink) were identified to species level using the Vitek YBC card (BioMerieux). In vitro susceptibility to amphotericin (AMB), fluconazole (FLU), itraconazole (ITZ), and voriconazole (VOR) was determined for approximately 40% of non-C. albicans yeasts using a standardised microdilution method. RESULTS Yeast was isolated from 1221 women (21%). Of these, C. albicans only was isolated from 1087 (89%) and yeasts other than C. albicans from 129 (11%) women. C. glabrata comprised 89 (69%) of the latter. Women in whom other yeasts were recovered were older than those with C. albicans (mean 43, versus 33 years, p <0.001). All isolates tested (n=53) were susceptible to AMB and VOR. Seven (24%) C. glabrata strains were susceptible to FLU with 21 (72%) testing susceptible-dose dependent. CONCLUSION Yeasts other than C. albicans are common vaginal isolates even in a primary care population. The species isolated are less susceptible to FLU than most C. albicans.
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Affiliation(s)
- J Holland
- Mayne Health-Laverty Pathology, NSW, Australia. ICPMR, Westmead Hospital, NSW, Australia.
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45
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Affiliation(s)
- J Ongrádi
- National Institute of Dermato-Venereology, Budapest VIII, Mária utca 41, Hungary 1085.
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46
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Abstract
Systemic infections with Erysipelothrix rhusiopathiae are usually associated with skin lesions, vegetative endocarditis and arthritis, but they can also cause reproductive symptoms such as abortion, increased stillbirths, and smaller litter size. In a large Hungarian breeding unit that had ceased to vaccinate the sows against erysipelas, an increased incidence of pre- and post-partal vulval discharge, increased weaning-to-oestrus intervals, decreased farrowing rates, and reductions in total number of pigets born and live-born litter size were reported. Anterior vaginal swabs were obtained from 64 sows shortly before parturition and they all yielded heavy growths of E. rhusiopathiae. A vaccination programme with a killed vaccine was reinstated and subsequently the incidence of vulval discharge and weaning-to-oestrus intervals were decreased and total born and live-born litter size were increased. In the absence of a control group definitive conclusions can not be made regarding the effect of vaccination against E. rhusiopathiae on sow fertility. However, it is not unreasonable to suggest that the aetiology of the reduced sow fertility in the present herd did involve E. rhusiopathiae and that appropriate vaccinations subsequently protected the sows from the disease.
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Smith EM, Ritchie JM, Galask R, Pugh EE, Jia J, Ricks-McGillan J. Case-control study of vulvar vestibulitis risk associated with genital infections. Infect Dis Obstet Gynecol 2002; 10:193-202. [PMID: 12648313 PMCID: PMC1784623 DOI: 10.1155/s1064744902000224] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE To evaluate the risk of vulvar vestibulitis syndrome (VVS) associated with genital infections in a case-control study. METHODS Diagnosed cases with VVS (n = 69) and age-frequency-matched healthy controls (n = 65) were enrolled from gynecology clinics in a university medical hospital during 1999. They were compared for potential risk factors and symptoms of disease. RESULTS VVS cases had a significantly higher risk of physician-reported bacterial vaginosis (BV) (odds ratio, OR = 9.4), Candida albicans (OR = 5.7), pelvic inflammatory disease (PID) (OR = 11.2), trichomoniasis (OR = 20.6), and vulvar dysplasia (OR = l5.7) but no risk associated with human papillomavirus (HPV), ASCUS, cervical dysplasia, genital warts, chlamydia, genital herpes or gonorrhea. Genital symptoms reported significantly more often with VVS included vulvar burning (91 vs. 12%), dyspareunia (81 vs. 15%), vulvar itching (68 vs. 23%) and dysuria (54 vs. 19%) (p < 0.0001). CONCLUSION A history of genital infections is associated with an increased risk of VVS. Long-term follow-up case-control studies are needed to elucidate etiologic mechanisms, methods for prevention and effective treatment.
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Affiliation(s)
- Elaine M Smith
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA 52242, USA.
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48
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Catala A, Simha V, Guillotel B, Rousseau MC. [Genital infection with Oligella urethralis]. Presse Med 2001; 30:1007-8. [PMID: 11433687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/20/2023] Open
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49
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Jaing TH, Huang CS, Chiu CH, Huang YC, Kong MS, Liu WM. Surgical implications of pseudomonas aeruginosa necrotizing fasciitis in a child with acute lymphoblastic leukemia. J Pediatr Surg 2001; 36:948-50. [PMID: 11381435 DOI: 10.1053/jpsu.2001.23998] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Necrotizing fasciitis caused by Pseudomonas aeruginosa is extremely rare. Only 4 cases were reported in the literature. The authors report the occurrence of P aeruginosa necrotizing fasciitis starting out as a vulval abscess in a girl before induction chemotherapy for acute lymphoblastic leukemia. To our knowledge, this is the second case described in association with leukemia. In this case, the outcome was favorable because of early surgical intervention, confirming the diagnosis. J Pediatr Surg 36:948-950.
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Affiliation(s)
- T H Jaing
- Division of Pediatric Hematology and Oncology, Department of Medicine, Chang Gung Children's Hospital, Taoyuan, Taiwan
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50
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Guaschino S, De Seta F, Sartore A, Ricci G, De Santo D, Piccoli M, Alberico S. Efficacy of maintenance therapy with topical boric acid in comparison with oral itraconazole in the treatment of recurrent vulvovaginal candidiasis. Am J Obstet Gynecol 2001; 184:598-602. [PMID: 11262459 DOI: 10.1067/mob.2001.111938] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Our purpose was to examine the efficacy of a topical long-term treatment with boric acid versus an oral long-term treatment (itraconazole) in the cure and prevention of recurrent vulvovaginal candidiasis. STUDY DESIGN A prospective, nonrandomized study of patients affected by recurrent vulvovaginal candidiasis was undertaken. In 3 years we recruited 22 consecutive patients who underwent therapy with itraconazole (group 1) or boric acid (group 2). Women were followed up for 1 year, with clinic and microbiologic controls after 1, 3, 6, and 12 months after the first visit. RESULTS During the treatment, the positive culture results (15.1% vs 12.1%) and the signs and symptoms (33.3% vs. 24.2%) were similar within the 2 groups, with no significant statistical difference. With the withdrawal, after 6 months relapses were common in the 2 groups (54.5%). CONCLUSIONS Boric acid seems to be a valid and promising therapy both in the cure of the vaginal infection and in the prevention of relapses of recurrent vulvovaginal candidiasis, but its efficacy ends with the suspension of the therapy.
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Affiliation(s)
- S Guaschino
- Department of Obstetrics and Gynecology, University of Trieste, Istituto di Ricovero e Cura a Carattere Scientifico Burlo Garofolo, Trieste, Italy
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