title: Lipschütz genital ulceration: a rare manifestation of paratyphoid fever.
abstract: In 1913, a distinctive clinical entity of acute genital ulcer occurring in an adolescent girl with a non-venereal infectious aetiology was described by Lipschütz. Since the initial description, several aetiologies have been discussed, and among them, paratyphoid fever is very uncommon. After her return from a trip, a 25-year-old girl developed high fever and diarrhoea. Examination of the vulva revealed a genital ulcer. The rest of the general examination was normal. Blood cultures identified Salmonella paratyphi A, and a diagnosis of Lipschütz's ulcer associated with paratyphoid fever was made. Bacteriaemia was then treated with antibiotics and the vulvar ulceration rapidly disappeared. Lipschütz described a distinctive clinical entity of acute genital ulcers occurring in adolescents. To our knowledge, we report herein the second case associated with proved paratyphoid fever. The authors thus recommend that typhoid or paratyphoid fever should be included in the differential diagnosis of genital ulcerations.
authors.affiliation: Service de Dermatologie 1, Hôpital Saint-Jacques, 2, place Saint-Jacques, 25030 Besançon cedex, France.
authors.forename: Fabien
authors.initials: F
authors.lastname: Pelletier
authors.forename: François
authors.initials: F
authors.lastname: Aubin
authors.forename: Eve
authors.initials: E
authors.lastname: Puzenat
authors.forename: Philippe
authors.initials: P
authors.lastname: Deprez
authors.forename: Dominique
authors.initials: D
authors.lastname: Blanc
authors.forename: Jean-Marie
authors.initials: JM
authors.lastname: Estavoyer
authors.forename: Philippe
authors.initials: P
authors.lastname: Humbert
mesh_terms: D000328:Adult; D003937:Diagnosis, Differential; D003967:Diarrhea / Q000209:etiology; D005260:Female; D006801:Humans; D010284:Paratyphoid Fever / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D012482:Salmonella paratyphi A / Q000302:isolation & purification; D014456:Ulcer / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D014845:Vulvar Diseases / Q000150:complications / Q000175:diagnosis* / Q000473:pathology