Isolation of Chlamydia trachomatis and Neisseria gonorrhoeae from the genital tract of sexually abused prepubertal females

Vaginal cultures for Chlamydia trachomatis were obtained from 195 prepubertal female children (2-12 years of age) evaluated for reported sexual abuse. The rate of positive cultures for C. trachomatis in this population was 2.6% (5/195). Neisseria gonorrhoeae was also recovered in 2.6% (5/195) of these patients. Concomitant infection with N. gonorrhoeae was found in one girl who was culture positive for C. trachomatis. Only 21 (11%) of the evaluated patients had a vaginal discharge, however, purulent vaginal discharge was noted in all children with positive vaginal cultures (9/9). The positive predictive value of vaginal discharge for these sexually transmitted diseases was 43% (9/21). C. trachomatis was isolated as often as N. gonorrhoeae in this population of prepubertal children. The data suggest that although these organisms are not often recovered from prepubertal girls being evaluated for sexual abuse, those with purulent vaginal discharge should be cultured for both C. trachomatis and N. gonorrhoeae