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A 6 month old female infant is referred in from PMD for concerns regarding the GU exam. Physical examinations at the 2 and 4 month old visits were normal. There are findings of concern for an STI.
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April 26, 2022 at 8:00 pm
D) Neisseria gonorrhea
Neisseria gonorrhea not seen in the immediate postnatal period and therefore acquired during childbirth is the main sexually transmitted infection considered definitely due to child sexual abuse. Postnatal syphilis and HIV infections, if clearly not transmitted intrapartum, are also strong evidence for child sexual abuse. Perinatally acquired HPV (genital warts) can present up to approximately 2 years of age, and Chlamydia up to 3 years of age. Perinatally acquired trichomonas can present up to approximately 1 year of age, but is highly likely to represent child sexual abuse in the prepubertal child. HSV, both type 1 and 2, can be transmitted both sexually and non-sexually, and while genital lesions and HSV type 2 may be more consistent with child sexual abuse, neither are definite.