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Case of the Month - March 2016

Case of the Month – March 2016

Dr Bernadett Gosnell - King Edward VIII hospital/ NR Mandela School of Medicine, Durban
Ms Kavitha Naidoo – Dept of Infection Prevention and Control, University of Kwa-Zulu Natal, Durban
Prof MYS Moosa- King Edward VIII hospital/ NR Mandela School of Medicine, Durban
Prof AW Sturm - Dept of Infection Prevention and Control, University of Kwa-Zulu Natal, Durban

We describe a case of an HIV-infected, 27 year old female patient with a 5 year history of 1st line efavirenz-based antiretroviral therapy with long periods of defaulting treatment (CD4: 2 cells/µL and HIV viral load 80,000 copies/ mL). She presented with an enlarging, bleeding ulcer on her left introitus, which started 8 months prior with an indurated, painful nodule on the inner aspect of the left labia minora, which ulcerated spontaneously. No inguinal lymph nodes were palpable. She received benzathine penicillin 2.4 Mio IU by intramuscular injection as a single dose, erythromycin 500 mg orally six hourly for 1 week and acyclovir 400 mg orally eight hourly for one week without resolution of the lesion.

Question 1: What is the differential diagnosis for a genital ulcer?


Continue to Answer 1

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