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[Gonococcal vulvovaginitis in prepubertal girls: sexual abuse or accidental transmission?].
Arch Pediatr 2013; 20(1):37-40AP

Abstract

Vulvovaginitis is the most frequent gynecologic pathology among prepubertal females. An infectious cause is found in 30% of cases and is highly associated with the presence of vaginal discharge upon examination. Neisseria gonorrhoeae may be one of the causative agents. Since N. gonorrhoeae is a common sexually transmitted disease, sexual abuse should be considered in the pediatric setting. We report the case of a 5-year-old girl with N. gonorrhoeae vulvovaginitis. Her previous history, multiple interviews with the patient and her parents, and clinical examination showed no evidence or signs of sexual abuse. Both parents presented gonorrhea, urethritis for the father and vaginitis for the mother. The discrepancy between pediatric evaluation and the presence of a bacterium associated with sexually transmitted disease led us to consider other means of contamination. Previous studies have shown that other routes of transmission are possible but are often neglected. Hence, contamination can be transmitted by the hands or mostly through passive means (towels, rectal thermometer, etc.). Many epidemics have been noted in group settings with young girls with no evidence of sexual transmission. Therefore, we concluded that this patient's infection was likely an accidental transmission within her family. The acknowledgement of these transmission routes is very important in order to avoid misguided suspicion of sexual abuse and the possible traumatic family and psychosocial consequences.

Authors+Show Affiliations

Service d'urgences pédiatriques, hôpital Femme-Mère-Enfant, Bron, France.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
English Abstract
Journal Article

Language

fre

PubMed ID

23219271

Citation

Daval-Cote, M, et al. "[Gonococcal Vulvovaginitis in Prepubertal Girls: Sexual Abuse or Accidental Transmission?]." Archives De Pediatrie : Organe Officiel De La Societe Francaise De Pediatrie, vol. 20, no. 1, 2013, pp. 37-40.
Daval-Cote M, Liberas S, Tristan A, et al. [Gonococcal vulvovaginitis in prepubertal girls: sexual abuse or accidental transmission?]. Arch Pediatr. 2013;20(1):37-40.
Daval-Cote, M., Liberas, S., Tristan, A., Vandenesch, F., & Gillet, Y. (2013). [Gonococcal vulvovaginitis in prepubertal girls: sexual abuse or accidental transmission?]. Archives De Pediatrie : Organe Officiel De La Societe Francaise De Pediatrie, 20(1), pp. 37-40. doi:10.1016/j.arcped.2012.10.011.
Daval-Cote M, et al. [Gonococcal Vulvovaginitis in Prepubertal Girls: Sexual Abuse or Accidental Transmission?]. Arch Pediatr. 2013;20(1):37-40. PubMed PMID: 23219271.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Gonococcal vulvovaginitis in prepubertal girls: sexual abuse or accidental transmission?]. AU - Daval-Cote,M, AU - Liberas,S, AU - Tristan,A, AU - Vandenesch,F, AU - Gillet,Y, Y1 - 2012/12/04/ PY - 2012/07/02/received PY - 2012/08/22/revised PY - 2012/10/15/accepted PY - 2012/12/11/entrez PY - 2012/12/12/pubmed PY - 2013/7/20/medline SP - 37 EP - 40 JF - Archives de pediatrie : organe officiel de la Societe francaise de pediatrie JO - Arch Pediatr VL - 20 IS - 1 N2 - Vulvovaginitis is the most frequent gynecologic pathology among prepubertal females. An infectious cause is found in 30% of cases and is highly associated with the presence of vaginal discharge upon examination. Neisseria gonorrhoeae may be one of the causative agents. Since N. gonorrhoeae is a common sexually transmitted disease, sexual abuse should be considered in the pediatric setting. We report the case of a 5-year-old girl with N. gonorrhoeae vulvovaginitis. Her previous history, multiple interviews with the patient and her parents, and clinical examination showed no evidence or signs of sexual abuse. Both parents presented gonorrhea, urethritis for the father and vaginitis for the mother. The discrepancy between pediatric evaluation and the presence of a bacterium associated with sexually transmitted disease led us to consider other means of contamination. Previous studies have shown that other routes of transmission are possible but are often neglected. Hence, contamination can be transmitted by the hands or mostly through passive means (towels, rectal thermometer, etc.). Many epidemics have been noted in group settings with young girls with no evidence of sexual transmission. Therefore, we concluded that this patient's infection was likely an accidental transmission within her family. The acknowledgement of these transmission routes is very important in order to avoid misguided suspicion of sexual abuse and the possible traumatic family and psychosocial consequences. SN - 1769-664X UR - https://www.unboundmedicine.com/medline/citation/23219271/[Gonococcal_vulvovaginitis_in_prepubertal_girls:_sexual_abuse_or_accidental_transmission]_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0929-693X(12)00458-7 DB - PRIME DP - Unbound Medicine ER -