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+Eight-year-old girl, of Bolivian origin, consulted our health centre for intermittent vaginal bleeding and mucopurulent, foul-smelling vaginal discharge for the last two months. Physical examination revealed severe congestion and oedema of the hymen and vulvar introitus. The girl lives with her parents and a paternal uncle and his partner at the same address and they deny any evidence of sexual abuse. Given this florid clinical picture, she was referred to the emergency department for differential diagnosis of vaginal foreign body and to rule out sexual abuse. A gynaecological examination was performed, where a vaginal foreign body was ruled out and a vaginal exudate sample was collected. In turn, she was assessed by the on-call forensic doctor, who issued a judicial report ruling out signs of sexual abuse. The culture of the vaginal exudate was positive for Shigella sonnei resistant according to the antibiogram to amoxicillin/clavulanic acid, ampicillin and the combination trimethoprim/sulfamethoxazole, and sensitive to cefuroxime axetil, cefixime and gentamicin. A stool culture, perianal exudate culture and urine culture were also requested and were negative. It was decided to prescribe antibiotic treatment with cefuroxime axetil for ten days, showing great clinical improvement, but without complete resolution of the symptoms, so the same treatment regimen was repeated, with the clinical symptoms disappearing.
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