Vaginal bleeding in prepubertal females: a case of Shigella vaginitis and review of literature

ML Gershman, J Simms-Cendan - BMJ Case Reports CP, 2022 - casereports.bmj.com
ML Gershman, J Simms-Cendan
BMJ Case Reports CP, 2022casereports.bmj.com
Shigella vulvovaginitis is an uncommon aetiology of prepubertal vaginal bleeding that
should be considered in the differential diagnosis, especially in patients who have travelled
to developing countries. A young girl presented with prepubertal vaginal bleeding, pelvic
pain, occasional dysuria and no gastrointestinal symptoms. After a year-long extensive
workup, including vaginoscopy and biopsy, genital culture and Gram stain revealed
vulvovaginitis due to Shigella flexneri. After review of bacterial sensitivity, the patient was …
Shigella vulvovaginitis is an uncommon aetiology of prepubertal vaginal bleeding that should be considered in the differential diagnosis, especially in patients who have travelled to developing countries. A young girl presented with prepubertal vaginal bleeding, pelvic pain, occasional dysuria and no gastrointestinal symptoms. After a year-long extensive workup, including vaginoscopy and biopsy, genital culture and Gram stain revealed vulvovaginitis due to Shigella flexneri. After review of bacterial sensitivity, the patient was given a 30-day course of sulfamethoxazole-trimethoprim. The patient returned to the clinic 1 month later with no signs of vaginal bleeding, discharge or pelvic pain. This case prompted review of the indicated evaluation and differential diagnosis of prepubertal vaginal bleeding, including infectious aetiologies such as Shigella vulvovaginitis with the authors’ goal to expedite diagnosis and treatment in paediatric patients.
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