A 13-year-old girl was hospitalized with genital ulcers possibly related to COVID-19, and she had to have labia surgery
A 13-year-old girl underwent labia surgery after developing painful genital ulcers in relation to COVID-19, which made it difficult for her to pee and walk.
The doctors, who treated the girl in Washington DC, wrote about what they believe to be a first-of-its-kind case in a May 5 case study in the journal BMJ Case Reports.
When she first got to the hospital, the girl told doctors she noticed the genital lesions three days after she developed chills, a fever, a sore throat, and inability to taste. The girl also tested positive for COVID-19 while at the hospital.
But that wasn't the end of the her hospital visit.
In what her parents described to the doctors as a "traumatic" experience, the girl underwent labia surgery because of blood clots that formed in her genital area during the ulcer flare-up.
"It was the length of the healing process that was the most frustrating, along with the continued pain with urination. She also had a lot of problems walking or moving around in general due to the pain," the parents told the doctors.
Genital ulcers and lesions are typically a symptom of rare disorders like Behçet's syndrome and Epstein-Barr virus and sexually transmitted infections like herpes, syphilis, and HIV, the doctors wrote in their case report, so they tested the girl for these conditions.
Two weeks prior to surgery, the girl said it was painful to pee.
She was sexually inactive and tested negative for all of the conditions besides COVID-19, so doctors sent her home with steroid creams and a topical numbing cream. But the ulcers were so painful, she had trouble applying the creams, which led the doctors to swap them out for oral steroids, instead.
She ended up spending two weeks in the hospital, where she took oral steroids daily, and used topical steroids on her vulva. When the ulcers shrunk but didn't go away entirely, the doctors decided to give her colchicine, an anti-inflammatory drug usually used to treat gout, a type of arthritis.
A week later, the girl finally felt relief as her pain and the ulcers began to subside. That's when her doctors realized she needed surgery.
Without surgery, the doctors said, the girl's red blood cells would have clogged her blood vessels and permanently stopped blood flow to her genitals.
Though rare, genital ulcers can lead to blood clots because ulcers inflame the blood vessels underneath them. When inflammation occurs, blood cannot travel through the veins and clots in one place. The doctors who penned the study said they opted for surgery because the ulcers didn't go away on their own and needed to be manually removed.
Once the girl healed from surgery, her genitals looked normal, according to the authors of the case report, and she didn't have scarring or pain.