A 6-year-old girl with chronic vaginal discharge

摘要

A 6-year-old girl was seen in the pediatric clinic for complaints of yellow vaginal discharge, present every day for the past 1.5 years. A few drops of bright red blood had been seen on her underwear in addition to the discharge approximately 1 to 2 times per week. The patient had just returned to the United States after a 2-year stay in Mexico. Her mother reported that the patient was seen by physicians in Mexico and treated with oral medications on 4 separate occasions. She did not remember the name of the medications used but reported a brief improvement in symptoms after each treatment. Each time, however, the symptoms returned shortly after cessation of treatment. During this time, the patient also reported dysuria, but she denied nocturia, enuresis, or incontinence. Her mother denied any suspicion of abuse, sexual or otherwise, and stated that she is always with the patient. The patient denied that any other person had tried to touch her genital area. The patient also denied inserting any foreign body into her vagina. The mother and patient denied any abdominal pain, fever, rhinorrhea, eye or nose discharge, nausea, vomiting, diarrhea, constipation, or blood in her stool. The patient’s past medical history and family history were unremarkable, and the social history revealed no concerns for sexual abuse.