Vulvovaginitis gonococcal in a child A case report

Background: Gonococcal or gonorrhea infection is one of the most common sexually transmitted infections (STIs). This infection is caused by Neisseria gonorrhoeae, a Gram-negative aerobic diplococcus. Gonorrhea is transmitted primarily through sexual intercourse, especially in the sexually active age, between 15-29 years. Gonococcal vaginitis is the most common form of gonorrhea in children. The infection in children generally indicates the existence of sexual contacts that require proper management. Although infrequent, nonsexual gonorrhea transmission, either from vomit, physical contact or autoinoculation may occur in children. Case: A vulvovaginitis was found in 7-year-old Balinese girl. She was diagnosed with gonococcal infection based on the anamnesis, physical examination and laboratory examination from vagina discharge with gram stain and culture. She was treated with oral Cefixime 200 mg tablet in a single dose and obtained clinical and laboratory improvement within the period of observation for eight days. Further examination and management of the patient’s parents are also performed. Discussion: Oral cefixime is preferred for children because the route of administration is not traumatic, and have a lower price with equally good effectiveness compared to injections. There were no signs of sexual violence, and no gonococcal infection was found in the family. It is suggested that it was transmitted from nonsexual contact from the patient’s friend; however, the source of infection need to be further investigated.