NECROTIZING GENITAL ULCERATIONS IN A PREMENARCHEAL FEMALE WITH MONONUCLEOSIS

Background: Two cases of genital ulcerations caused by Epstein-Barr vi rus have been reported previously, one in a sexually active 23-year-ol d and another in a 14-year-old practicing cunnilingus. Case: We report a case of Epstein-Barr virus genital ulcerations in a premenarcheal v irgin. Her systemic symptoms were atypical for mononucleosis. Necrotiz ing genital ulcerations preceded pharyngitis and oral lesions. Cervica l adenopathy, fever, and splenomegaly never developed despite serologi c evidence of acute mononucleosis. Conclusion: Genital ulcerations can be the initial manifestation of Epstein-Barr virus in adolescents who are neither sexually active nor immunocompromised. (Obstet Gynecol 19 98;92:642-4. (C) 1998 by The American College of Obstetricians and Gyn ecologists.)