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.

译文

:阴道炎是青春期前女性中最常见的妇科病理学。在30%的病例中发现了感染原因,并且与检查时是否存在白带高度相关。淋病奈瑟菌可能是其病原体之一。由于淋病奈瑟氏球菌是一种常见的性传播疾病,因此在儿科环境中应考虑性虐待。我们报告了一名5岁女孩患有淋病奈瑟菌性阴道炎的病例。她以前的病史,与患者及其父母的多次访谈以及临床检查均未发现任何性虐待迹象或迹象。父母双方均表现为淋病,父亲为尿道炎,母亲为阴道炎。儿科评估和与性传播疾病相关的细菌的存在之间的差异,导致我们考虑其他污染手段。先前的研究表明,其他传播途径也是可能的,但常常被忽略。因此,污染物可以通过手传播,或者主要通过被动方式(毛巾,直肠温度计等)传播。在没有女孩发生性传播迹象的年轻女孩的集体场合中,已经注意到许多流行病。因此,我们得出的结论是,该患者的感染很可能是其家庭内部的意外传播。为了避免误导性怀疑性虐待以及可能造成的家庭和社会心理后果,对这些传播途径的认识非常重要。

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