{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T04:31:13Z","timestamp":1768451473362,"version":"3.49.0"},"reference-count":13,"publisher":"American Academy of Pediatrics (AAP)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1999,12,1]]},"abstract":"<jats:sec>\n                  <jats:title>Objective.<\/jats:title>\n                  <jats:p>This study examined the prevalence of gonorrhea in girls &amp;lt;12 years of age who presented with vaginitis and in whom sexual abuse was not suspected.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design.<\/jats:title>\n                  <jats:p>A prospective, consecutive patient series was performed in a pediatric emergency department with 90\u2009000 visits per year and in 2 affiliated pediatric continuity clinics. All girls (Tanner I or II) between the ages of 12 months and 12 years, presenting with a chief complaint of vaginal discharge, burning, pain, or itching, were enrolled (n = 93). Patients were excluded (n = 6) if there was a history of sexual abuse. The presence or absence of vaginal discharge, vaginal erythema, or trauma was recorded. Physicians were instructed to collect cultures forNeisseria gonorrhea (GC), Chlamydia trachomatis, and bacteria\/yeast. Wet prep, urinalysis, urine culture, serum rapid plasma reagin, and fungal culture were obtained at the physician's discretion.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results.<\/jats:title>\n                  <jats:p>Of the girls, 43 had a vaginal discharge on examination. Of these girls, 4 (9%) had GC, 9 (26%) had group A, B, or F streptococcus and 1 had Staphylococcus aureus. Of the girls, 44 had no discharge on examination. In this group, 3 had streptococcus infection and 2 had Candida albicans. Both children with C albicans had been treated recently with systemic antibiotics. Those girls with a vaginal discharge on examination had a microbial etiology significantly more often than did those without discharge. All of the girls with infection were Tanner I on genital examination.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions.<\/jats:title>\n                  <jats:p>The prevalence of unsuspected GC infection was high and emphasizes the importance of culturing Tanner I girls for GC when they have a vaginal discharge along with routine bacterial cultures. Testing and\/or treating for C albicans should be considered when there has been recent antibiotic use. Girls with vaginal complaints but without vaginal discharge may have a bacterial infection, but such diagnoses occur less frequently than with girls who have a discharge.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1542\/peds.104.6.e72","type":"journal-article","created":{"date-parts":[[2004,8,13]],"date-time":"2004-08-13T23:45:45Z","timestamp":1092440745000},"page":"e72-e72","source":"Crossref","is-referenced-by-count":32,"title":["<i>Neisseria gonorrhea<\/i> Infections in Girls Younger Than 12 Years of Age Evaluated for Vaginitis"],"prefix":"10.1542","volume":"104","author":[{"given":"Robert A.","family":"Shapiro","sequence":"first","affiliation":[{"name":"From the Division of Emergency Medicine, Children's Hospital Medical Center, the"},{"name":"Department of Pediatrics, University of Cincinnati, Cincinnati, Ohio; and the"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charles J.","family":"Schubert","sequence":"additional","affiliation":[{"name":"From the Division of Emergency Medicine, Children's Hospital Medical Center, the"},{"name":"Department of Pediatrics, University of Cincinnati, Cincinnati, Ohio; and the"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert M.","family":"Siegel","sequence":"additional","affiliation":[{"name":"Northern Kentucky Children's Advocacy Center, St Luke Pediatric Care Center, Bellevue, Kentucky."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"417","published-online":{"date-parts":[[1999,12,1]]},"reference":[{"key":"2021121003114037100_B1","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1097\/00006565-199312000-00004","article-title":"Vaginal discharge as an indicator of gonorrhea and Chlamydia infection in girls under 12 years old.","volume":"9","author":"Shapiro","year":"1993","journal-title":"Pediatr Emerg Care"},{"key":"2021121003114037100_B2","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1542\/peds.60.2.153","article-title":"Gonorrhea in preadolescent children: an inquiry into source of infection and mode of transmission.","volume":"60","author":"Folland","year":"1977","journal-title":"Pediatrics"},{"key":"2021121003114037100_B3","first-page":"1090","article-title":"The prevalence of sexually transmitted diseases in children and adolescents evaluated for sexual abuse in Cincinnati: rationale for limited STD testing in prepubertal girls.","volume":"96","author":"Siegel","year":"1995","journal-title":"Pediatrics"},{"key":"2021121003114037100_B4"},{"key":"2021121003114037100_B5","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1016\/S1083-3188(96)70015-3","article-title":"Child sexual abuse examination: is there a need for routine screening for N. gonorrhoeae?","volume":"9","author":"Muram","year":"1996","journal-title":"Pediatr Adolesc Gynecol"},{"key":"2021121003114037100_B6","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1097\/00006454-198201000-00010","article-title":"Group A streptococcal vaginitis in children.","volume":"1","author":"Ginsburg","year":"1982","journal-title":"Pediatr Infect Dis."},{"key":"2021121003114037100_B7","doi-asserted-by":"crossref","first-page":"446","DOI":"10.1097\/00007611-198204000-00017","article-title":"Vulvovaginitis in prepubertal girls: the importance of group A streptococcus.","volume":"75","author":"Schwartz","year":"1982","journal-title":"South Med J"},{"key":"2021121003114037100_B8","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1111\/j.1525-1470.1993.tb00401.x","article-title":"Streptococcal vulvovaginitis in girls.","volume":"10","author":"Dhar","year":"1993","journal-title":"Pediatr Dermatol"},{"key":"2021121003114037100_B9","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1542\/peds.62.1.57","article-title":"Microbiology of the vagina in children: normal and potentially pathogenic organisms.","volume":"62","author":"Hammerschlag","year":"1978","journal-title":"Pediatrics"},{"key":"2021121003114037100_B10","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1542\/peds.70.2.193","article-title":"Vulvovaginitis in premenarcheal girls: clinical features and diagnostic evaluation.","volume":"70","author":"Paradise","year":"1982","journal-title":"Pediatrics"},{"key":"2021121003114037100_B11","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1136\/adc.67.4.509","article-title":"Vulvovaginitis: causes and management.","volume":"67","author":"Pierce","year":"1992","journal-title":"Arch Dis Child"},{"key":"2021121003114037100_B12","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1093\/fampra\/13.4.369","article-title":"Childhood vulvovaginitis and vaginal discharge in general practice.","volume":"13","author":"Jones","year":"1996","journal-title":"Fam Pract"},{"key":"2021121003114037100_B13","first-page":"311","article-title":"Microbiological study of vulvovaginitis in premenarcheal girls.","volume":"14","author":"Pena","year":"1996","journal-title":"Enferm Infecc Microbiol Clin"}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/104\/6\/e72\/887462\/pe1299000h1p.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/104\/6\/e72\/887462\/pe1299000h1p.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,10]],"date-time":"2021-12-10T09:43:00Z","timestamp":1639129380000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/104\/6\/e72\/62748\/Neisseria-gonorrhea-Infections-in-Girls-Younger"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1999,12,1]]},"references-count":13,"journal-issue":{"issue":"6","published-online":{"date-parts":[[1999,12,1]]},"published-print":{"date-parts":[[1999,12,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.104.6.e72","relation":{},"ISSN":["1098-4275","0031-4005"],"issn-type":[{"value":"1098-4275","type":"electronic"},{"value":"0031-4005","type":"print"}],"subject":[],"published":{"date-parts":[[1999,12,1]]}}}