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Indications for Neisseria gonorrhoeae cultures in children with suspected sexual abuse.
Arch Pediatr Adolesc Med 1995; 149(1):86-9AP

Abstract

OBJECTIVE

To determine the clinical predictors of Neisseria gonorrhoeae infection in children examined for sexual abuse.

DESIGN

Retrospective review of a prospective management plan.

SETTING

A 240-bed children's hospital with 36,000 emergency department visits per year.

INTERVENTION

In 1988, a Pediatric Emergency Medicine Department protocol was introduced for the examination of children who present with complaints suggestive of sexual abuse.

RESULTS

From January 1990 through December 1991, the records of all children less than 12 years of age examined for suspected sexual abuse were reviewed. Vaginal/urethral, oral, and rectal cultures for N gonorrhoeae were performed in 316 children. Seven children (2.2%) had a total of 12 positive cultures: seven vaginal/urethral, four rectal, and one oral. Evidence of vaginal/urethral discharge on physical examination was the best predictor of N gonorrhoeae infection (sensitivity, 100%; specificity, 88%; positive predictive value, 16%; and negative predictive value, 100%). Historical and physical evidence of discharge was significantly associated with N gonorrhoeae infection (P < .0006 and P < .000001, respectively).

CONCLUSIONS

Children less than 12 years of age examined for sexual abuse who did not have evidence on physical examination of vaginal or urethral discharge were found to have a 100% probability of having negative vaginal/urethral, oral, and rectal N gonorrhoeae cultures. These findings do not support the practice of obtaining cultures for N gonorrhoeae routinely in all children who present for evaluation of possible sexual abuse.

Authors+Show Affiliations

Department of Pediatric Emergency Services, Children's Hospital of St Paul, Minn.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

7827668

Citation

Sicoli, R A., et al. "Indications for Neisseria Gonorrhoeae Cultures in Children With Suspected Sexual Abuse." Archives of Pediatrics & Adolescent Medicine, vol. 149, no. 1, 1995, pp. 86-9.
Sicoli RA, Losek JD, Hudlett JM, et al. Indications for Neisseria gonorrhoeae cultures in children with suspected sexual abuse. Arch Pediatr Adolesc Med. 1995;149(1):86-9.
Sicoli, R. A., Losek, J. D., Hudlett, J. M., & Smith, D. (1995). Indications for Neisseria gonorrhoeae cultures in children with suspected sexual abuse. Archives of Pediatrics & Adolescent Medicine, 149(1), pp. 86-9.
Sicoli RA, et al. Indications for Neisseria Gonorrhoeae Cultures in Children With Suspected Sexual Abuse. Arch Pediatr Adolesc Med. 1995;149(1):86-9. PubMed PMID: 7827668.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Indications for Neisseria gonorrhoeae cultures in children with suspected sexual abuse. AU - Sicoli,R A, AU - Losek,J D, AU - Hudlett,J M, AU - Smith,D, PY - 1995/1/1/pubmed PY - 1995/1/1/medline PY - 1995/1/1/entrez SP - 86 EP - 9 JF - Archives of pediatrics & adolescent medicine JO - Arch Pediatr Adolesc Med VL - 149 IS - 1 N2 - OBJECTIVE: To determine the clinical predictors of Neisseria gonorrhoeae infection in children examined for sexual abuse. DESIGN: Retrospective review of a prospective management plan. SETTING: A 240-bed children's hospital with 36,000 emergency department visits per year. INTERVENTION: In 1988, a Pediatric Emergency Medicine Department protocol was introduced for the examination of children who present with complaints suggestive of sexual abuse. RESULTS: From January 1990 through December 1991, the records of all children less than 12 years of age examined for suspected sexual abuse were reviewed. Vaginal/urethral, oral, and rectal cultures for N gonorrhoeae were performed in 316 children. Seven children (2.2%) had a total of 12 positive cultures: seven vaginal/urethral, four rectal, and one oral. Evidence of vaginal/urethral discharge on physical examination was the best predictor of N gonorrhoeae infection (sensitivity, 100%; specificity, 88%; positive predictive value, 16%; and negative predictive value, 100%). Historical and physical evidence of discharge was significantly associated with N gonorrhoeae infection (P < .0006 and P < .000001, respectively). CONCLUSIONS: Children less than 12 years of age examined for sexual abuse who did not have evidence on physical examination of vaginal or urethral discharge were found to have a 100% probability of having negative vaginal/urethral, oral, and rectal N gonorrhoeae cultures. These findings do not support the practice of obtaining cultures for N gonorrhoeae routinely in all children who present for evaluation of possible sexual abuse. SN - 1072-4710 UR - https://www.unboundmedicine.com/medline/citation/7827668/Indications_for_Neisseria_gonorrhoeae_cultures_in_children_with_suspected_sexual_abuse_ L2 - https://jamanetwork.com/journals/jamapediatrics/fullarticle/vol/149/pg/86 DB - PRIME DP - Unbound Medicine ER -