Cases reported "Vulvar Diseases"

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1/4. Bilateral postpartum vulvar edema associated with maternal death.

    Reported is a maternal death associated with bilateral postpartum vulvar edema. Data are reviewed for this patient and four other patients who were previously reported to have had a syndrome of unilateral postpartum vulvar edema associated with maternal death. overall, an 80% mortality rate has been observed.
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ranking = 1
keywords = maternal death, death
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2/4. Maternal deaths associated with postpartum vulvar edema.

    Reported are three maternal deaths in four patients who presented with a similar syndrome following a normal antepartum course and normal labor and delivery managed by regional or local anesthesia and midline or proctoepisiotomy. Beginning about the second postpartum day, the patients developed unilateral perineal edema and induration which progressed to generalized vulvar, vaginal, perineal, and gluteal edema and induration. These patients developed marked leukocytosis, fever, and ultimately vascular collapse; three of them died. The one patient who survived had a similar course except for vascular collapse. Unilateral vulvar induration and edema associated with fever and marked leukocytosis are ominous signs. Aggressive treatment should include the use of multiple antibiotic, crystaloid, colloid, and steroid drugs and appropriate monitoring. By this report we hope to bring attention to this rare but lethal syndrome.
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ranking = 0.16669624459465
keywords = maternal death, death
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3/4. Massive vulvar edema complicating tocolysis in a patient with twins. A case report.

    BACKGROUND: Severe vulvar edema is an extremely rare complication of pregnancy. One other case of tocolysis-induced vulvar edema has been reported, as have five cases of postpartum vulvar edema, associated with an 80% maternal mortality rate. CASE: A multipara with a twin gestation presented with premature labor at 31 weeks. The patient had no history of trauma, lymphatic obstruction, venous obstruction or infection. On the fifth day of tocolysis with magnesium sulfate, nifedipine, terbutaline and betamethasone, edema developed in both labia. The following day the vulvar edema had increased and spread to the sacrum. The patient was normotensive and afebrile. Resolution occurred in spite of continuous tocolytic therapy, which was stopped at 35 weeks. Two days later, on hospital day 27, the patient spontaneously delivered two healthy, male infants. CONCLUSION: The two reported cases of tocolysis-induced vulvar edema were not fatal and resolved after repositioning the patient in one case and by cesarean section in the other. However, since maternal death has occurred with postpartum vulvar edema, the patient with vulvar edema merits special attention. The WBC count should be determined and the patient's circulatory status evaluated to rule out hypovolemia.
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ranking = 0.16666666666667
keywords = maternal death, death
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4/4. Bacillary angiomatosis of the cervix and vulva in a patient with AIDS.

    BACKGROUND: Bacillary angiomatosis is a clinicopathologic entity that most often is identified in the skin of patients with AIDS. This report presents an example of bacillary angiomatosis of the female genital tract. CASE: Bacillary angiomatosis presented as red-purple nodules of the vulva and cervix in a 32-year-old woman with AIDS. Histologic examination revealed the lobular epithelioid vascular proliferation and hazy clumps of bacteria that characterize bacillary angiomatosis. The diagnosis was confirmed on Warthin-Starry-stained issue and by blood cultures, which were positive for bartonella (Rochalimaea) henselae. CONCLUSION: Accurate diagnosis of this infection is important because 1) bacillary angiomatosis is commonly mistaken for Kaposi sarcoma, 2) it is effectively treated with inexpensive antibiotics, and 3) undiagnosed and/or untreated bacillary angiomatosis may lead to overwhelming disseminated infection and death.
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ranking = 7.3944819964713E-6
keywords = death
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