Child Sexual Abuse Examination: Is There a Need for Routine Screening for N gonorrhoeae and C trachomatis?

Purpose To determine the yield of routine vaginal cultures for Neisseria gonorrhoeae and Chlamydia trachomatis from girls evaluated following sexual abuse. Methods Retrospective chart review evaluating results of cultures that were obtained from 2008 prepubertal girls seen within 72 hours following an assault over two periods of 3 years each. Results It was found that only 16 (0.8%) of cultures were positive for either gonorrhea or chlamydia. All but one of the prepubertal girls who had positive vaginal cultures for sexually transmitted disease had signs of acute vulvovaginitis. Conclusion Routine vaginal cultures in asymptomatic pre-pubertal girls have a very low yield. Prospective studies are required to change current protocols for the evaluation of child victims of sexual abuse.