Foreign Body in Vagina: An Uncommon Cause of Vaginitis in Children
A 6-year-old girl who lived with her parents presented with recurrent foul-smelling, blood-stained vaginal discharge and dysuria for 2 years. There was no history of urinary frequency, abdominal pains or preceding sexual abuse. A history of foreign body insertion into the vagina by the child could not be established. Her mother had taken her to some private clinics where several antibiotics and vaginal creams were administered with no improvement. There was a harmonious parental relationship and no family discord.\nInitial examination revealed an apprehensive child with slight lower abdominal tenderness. Vaginal examination however was not done. Vaginal swab and urine cultures yielded Staphylococcus aureus (MRSA) sensitive to Ceftriaxone only. She was commenced on this antibiotic for 2 weeks, but the vaginal discharge continued, necessitating referral to a gynecologist. Examination under anesthesia by the gynecologist revealed very mild excoriations on the vaginal wall, intact hymen that appeared thin, smooth, delicate and nearly translucent, and shreds of toilet tissue paper extracted from the vagina by the use of a swab stick. The vaginal discharge stopped subsequently and the patient improved remarkably on syrup Cefuroxime given for 7 days. Consent was granted by the care giver for this report, but she declined consent for the use of her child's pictures for illustration due to personal reasons.