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- W2605333682 abstract "A 16-year-old girl presented to the emergency department of a community hospital with an eight-day history of fever. On the first day of illness, she noted mild upper respiratory tract symptoms that resolved within 24 h. During the following five days, she felt generally well with the exception of nocturnal fevers. Three days before presentation, she developed a painful ulcer on her left labium majus. She had normal bowel movements until the day of presentation when she had one loose, nonbloody bowel movement. She had been taking acetaminophen for two to three days as well as a first-generation cephalosporin for seven days, which the family had purchased in India. The patient denied any recent or remote sexual activity.The family had immigrated from India three weeks before the onset of her illness. Her medical and family history were unremarkable. She denied any sexual activity.Physical examination revealed a well-appearing adolescent with a temperature of 39.5°C as well as a single circular 2 cm × 2 cm white-topped ulcer on her left labium majus. The external genitalia were otherwise normal. The rest of a complete examination was unremarkable.Investigations in the emergency department included a normal complete blood count, negative malarial smear and mild trans-aminitis with an aspartate aminotransferase level of 105 U/L and an alanine aminotransferase level of 117 U/L. Herpes simplex virus and bacterial studies were performed on a swab of the lesion. A rapid plasma reagin test was performed to screen for syphilis, and blood cultures were drawn. She was discharged home with a plan for outpatient follow-up.Further investigation revealed the diagnosis." @default.
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- W2605333682 date "2011-02-01" @default.
- W2605333682 modified "2023-09-27" @default.
- W2605333682 title "Case 1: Fever and a genital ulcer in a recent immigrant" @default.
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- W2605333682 doi "https://doi.org/10.1093/pch/16.2.75" @default.
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