UMEM Educational Pearls

Category: Pediatrics

Title: Vaginal Cultures for Sexual Abuse Evaluation

Keywords: Gonorrhea, Chlamydia, Syphilis, Sexual Abuse, Trichomonas (PubMed Search)

Posted: 3/14/2008 by Sean Fox, MD (Updated: 10/18/2019)
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Sexual Abuse

 

  • The only positive vaginal culture that is DEFINITIVE confirmation of sexual abuse is Neisseria gonorrhea.
    • Vertically transmitted Chlamydia may persist for up to 3 years (does not confirm abuse in children <3yrs)
    • Syphilis may also be present due to vertical transmission (often presents as secondary syphilis)
    • Trichomonas can also be transmitted perinatally and may persist for 6-9 months. 
      • However, it has NOT been found in children >1 year without history of sexual contact.
  • Remember that CULTURES need to be sent for GC and Chlamydia.  DNA probes and nonculture methods are NOT recommended in this age group for evaluation of potential sexual abuse.