TY - JOUR PY - 1995// TI - Indications for Neisseria gonorrhoeae cultures in children with suspected sexual abuse JO - Archives of pediatrics and adolescent medicine A1 - Sicoli, R. A. A1 - Losek, J. D. A1 - Hudlett, J. M. A1 - Smith, D. SP - 86 EP - 89 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.

Language: en

LA - en SN - 1072-4710 UR - http://dx.doi.org/ ID - ref1 ER -