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

外阴阴道炎是青春期前女性中最常见的妇科病理。在30% 病例中发现了感染原因,并且在检查时与阴道分泌物的存在高度相关。淋球菌可能是病原体之一。由于淋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岁女孩患有淋球菌性外阴阴道炎的病例。她以前的病史,对患者及其父母的多次采访以及临床检查都没有发现性虐待的证据或迹象。父母双方都患有淋病,父亲患有尿道炎,母亲患有阴道炎。儿科评估与与性传播疾病相关的细菌之间的差异使我们考虑了其他污染手段。先前的研究表明,其他传播途径是可能的,但通常被忽略。因此,污染可以通过手或主要通过被动手段 (毛巾,直肠温度计等) 传播。在没有性传播证据的年轻女孩的团体环境中,已经发现了许多流行病。因此,我们得出结论,该患者的感染可能是其家庭内部的意外传播。为了避免对性虐待的误导怀疑以及可能造成的家庭和社会心理后果,承认这些传播途径非常重要。

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