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Table. Characteristics of Young Female Patients With Nonsexually Acquired Genital Ulceration (Lipschütz Ulcers) Associated With Mycoplasma fermentans Infection Characteristic

Case 1

Case 2

Case 3

Prodromal symptom

High-grade fever, nasal discharge, lymphadenopathy

High-grade fever, headache, right wrist pain, nasal discharge

High-grade fever, general fatigue

Left major labium ulcer

Left minor labium and posterior commissure ulcers

Both minor labia ulcers

None

None

Aphtha

Abbreviations: CMV, cytomegalovirus; EBV, Epstein-Barr virus; EIA, enzyme immunoassay; EIU, enzyme immunoassay units; HSV, herpes simplex virus; ND, not detected; VCA, virus capsid antigen.

Antigen of HSV (ulcer)a

ND

ND

ND

a

VCA IgG titer of EBV/EBV DNA, antibody index/viral loadb,c

80/ND

20/ND

40/ND

Direct immunofluorescence method.

b

Fluorescent antibody method.

c

In peripheral leukocytes using polymerase chain reaction.

d

Enzyme immunoassay (positive IgM, ⱖ0.8; positive IgG, ⱖ2.0).

e

Enzyme-linked immunosorbent assay (normal range, 0.09-0.47).

Lesion location Genital Oral

IgM/IgG titer of CMV, antibody index/EIA leveld

Extended Perineal Dermatobia hominis Myiasis in a Traveler Returning From South America.

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