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We report the unusual case of a girl diagnosed with<jats:italic>Neisseria\u00a0gonorrhoeae<\/jats:italic>after bathing in a heavily frequented hot pool at the edge of the crater lake Specchio di Venere (\u201cMirror of Venus\u201d) on Pantelleria Island, Italy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case presentation<\/jats:title><jats:p>Two days after bathing in the pool, this 11-year-old Austrian girl developed vulvovaginitis that partially settled with antifungal cream. Subsequent swabs cultured positive for<jats:italic>Neisseria\u00a0gonorrhoeae.<\/jats:italic>Family members tested negative. The child adamantly denied any sexual contact, and no opportunities for sexual exposure could be identified. It was therefore concluded that she must have acquired the infection from pool water contaminated by gonococcus after a 2-day incubation period. The infection was successfully treated with ceftriaxone and azithromycin with no adverse effects.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The pools are shallow, close to body temperature, isotonic, slightly acidic from CO<jats:sub>2<\/jats:sub>bubbles, and contain organic particles, all potentially supporting survival of gonococcus. There are historical case reports in the literature of gonococcal epidemics in children\u2019s hospitals being traced to common baths. It is imperative that all cases of gonococcal infection in children are fully investigated, including examining all other relevant family members, to determine whether sexual assault has occurred. This is not a diagnosis to be missed. However, both sexual and nonsexual transmission are possible. A presumption that a gonococcal infection is diagnostic of sexual abuse can be dire, with children wrongfully removed from their parents\u2019 care, and their caregivers facing false charges of sexual crimes. Our case serves to illustrate that the very uncommon diagnosis of gonorrhea in a child may be the result of nonsexual transmission of the infection, and that contaminated hot pools are a very rare source of infection that should be considered.<\/jats:p><\/jats:sec>","DOI":"10.1186\/s13256-021-03043-6","type":"journal-article","created":{"date-parts":[[2021,9,16]],"date-time":"2021-09-16T23:06:19Z","timestamp":1631833579000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Gonococcus infection probably acquired from bathing in a natural thermal pool: a case report"],"prefix":"10.1186","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6657-9401","authenticated-orcid":false,"given":"Felicity","family":"Goodyear-Smith","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Schabetsberger","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,9,17]]},"reference":[{"issue":"6","key":"3043_CR1","doi-asserted-by":"publisher","first-page":"483","DOI":"10.1136\/sti.2005.014621","volume":"81","author":"L Brabin","year":"2005","unstructured":"Brabin L, Roberts SA, Fairbrother E, et\u00a0al. 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