文献简介

出版社:JAMA Dermatology

作  者:Saeed El Zein, MD; Ossama Abbas, MD; Souha S. Kanj, MD

编  号:

关键字:巨细胞病毒性溃疡

年  份:2018   点击量:51

文献摘要 全文翻译

A woman in her 80s presented to hospital with somnolence and fatigue of 2 days’ duration. Medical history included lower urinary tract symptoms of 1-week duration for which she was prescribed cotrimoxazole with no improvement. She also reported progressively worsening vulvar and buttock pain of 5 days’ duration. The patient was admitted to the intensive care unit 3 weeks prior to presentation for pneumonia and remained hospitalized for 10 days. She was not sexually active and had no medical history of sexually transmitted infections. Anogenital examination revealed vulvar (Figure 1A)and buttock ulcers (Figure 1B) tender to palpation. Initial blood workup showed leukopenia with a white blood cell count of 2400 cells/μL (to convert to cells/L, multiply by 106), a differential of 72% neutrophils, and a hemoglobin level of 8.5 g/dL with a hematocrit differential of 27% (to convert hemoglobin to g/L, multiply by 10.0). Cotrimoxazole was discontinued on admission. A biopsy specimen was obtained from the left vulvar ulcer (Figure 1C).

患者女性,80余岁,因嗜睡和乏力2天入院。病史包括持续1周的下尿路症状,已给予复方新诺明治疗,但未改善。患者自述外阴和臀部疼痛持续5天并逐渐恶化。入院前3周患者因肺炎被送入重症监护病房,并住院10天。患者无活跃性生活,也未有性传播感染病史。肛门生殖器检查显示外阴(图1A)和臀部溃疡(图1B),触之疼痛。初步血液检查显示白细胞减少,白细胞计数为2400个/μL(转换为个/ L,乘以106),中性粒细胞差异为72%,血红蛋白水平为8.5 g / dL,血细胞比容差异为27%(将血红蛋白转换为g / L,乘以10.0)。患者入院时停用复方新诺明。从左外阴溃疡取活检标本(图1C)。