A Painful Presentation: Lipschütz Ulcer in an Adolescent With Recent Mononucleosis

Abstract

Lipschütz ulcer is a rare, nonsexually transmitted genital ulceration most commonly affecting nonsexually active adolescent females after systemic viral illness, particularly Epstein-Barr virus (EBV). Because these lesions often resemble sexually transmitted infections, they frequently prompt extensive diagnostic evaluation and aggressive treatment despite their self-limited course. This report describes a 13-year-old female patient who developed acute, painful vulvar ulcerations after infectious mononucleosis. Comprehensive infectious and autoimmune workup was negative. The patient was hospitalized and treated with antibiotics and topical therapies before clinical improvement occurred. This case highlights the potential for diagnostic cascade, unnecessary antimicrobial use, and avoidable health care utilization in a benign postviral condition. Greater awareness of Lipschütz ulcer may help clinicians reduce unnecessary interventions, minimize psychosocial distress, and promote evidence-based supportive management.