{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T00:02:26Z","timestamp":1756339346309,"version":"3.44.0"},"reference-count":17,"publisher":"BMJ","issue":"8","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2022,8,17]]},"published-print":{"date-parts":[[2022,8]]},"abstract":"<jats:p>\n                  <jats:italic>Shigella<\/jats:italic> vulvovaginitis is an uncommon aetiology of prepubertal vaginal bleeding that should be considered in the differential diagnosis, especially in patients who have travelled to developing countries. A young girl presented with prepubertal vaginal bleeding, pelvic pain, occasional dysuria and no gastrointestinal symptoms. After a year-long extensive workup, including vaginoscopy and biopsy, genital culture and Gram stain revealed vulvovaginitis due to <jats:italic>Shigella flexneri<\/jats:italic>. After review of bacterial sensitivity, the patient was given a 30-day course of sulfamethoxazole-trimethoprim. The patient returned to the clinic 1\u2009month later with no signs of vaginal bleeding, discharge or pelvic pain. This case prompted review of the indicated evaluation and differential diagnosis of prepubertal vaginal bleeding, including infectious aetiologies such as <jats:italic>Shigella<\/jats:italic> vulvovaginitis with the authors\u2019 goal to expedite diagnosis and treatment in paediatric patients.<\/jats:p>","DOI":"10.1136\/bcr-2022-251303","type":"journal-article","created":{"date-parts":[[2022,8,29]],"date-time":"2022-08-29T11:30:20Z","timestamp":1661772620000},"page":"e251303","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Vaginal bleeding in prepubertal females: a case of <i>Shigella<\/i> vaginitis and review of literature"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6657-120X","authenticated-orcid":false,"given":"Melanie L","family":"Gershman","sequence":"first","affiliation":[{"name":"University of Miami Miller School of Medicine, Miami, Florida, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Judith","family":"Simms-Cendan","sequence":"additional","affiliation":[{"name":"Obstetrics & Gynecology, University of Miami Miller School of Medicine, Miami, Florida, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2022,8,29]]},"reference":[{"key":"2025082623515814000_15.8.e251303.1","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1016\/S0932-8610(19)80085-3","article-title":"Shigella vulvovaginitis in prepubertal girls","volume":"7","author":"Gryngarten","year":"1994","journal-title":"Adolesc Pediatr Gynecol"},{"key":"2025082623515814000_15.8.e251303.2","unstructured":"Sanfilippo J , Lara-Torre E , Gomez-Lobo V . 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Pediatric Beh\u00e7et\u2019s Disease. Front. Med. 2021;8.doi:10.3389\/fmed.2021.627192","DOI":"10.3389\/fmed.2021.627192"},{"key":"2025082623515814000_15.8.e251303.13","doi-asserted-by":"crossref","first-page":"511","DOI":"10.1542\/peds.63.4.511","article-title":"Shigella vaginitis: report of 38 patients and review of the literature","volume":"63","author":"Murphy","year":"1979","journal-title":"Pediatrics"},{"key":"2025082623515814000_15.8.e251303.14","doi-asserted-by":"crossref","first-page":"574","DOI":"10.1016\/j.jpag.2019.08.009","article-title":"Clinical and microbiological findings of vulvovaginitis in prepubertal girls","volume":"32","author":"Jarien\u0117","year":"2019","journal-title":"J Pediatr Adolesc Gynecol"},{"key":"2025082623515814000_15.8.e251303.15","doi-asserted-by":"publisher","DOI":"10.1097\/00006454-199210000-00018"},{"key":"2025082623515814000_15.8.e251303.16","doi-asserted-by":"crossref","unstructured":"Bayramoglu G , Aydin F , Karaguzel G , et al . 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