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Vaginal bleeding in prepubertal females: a case of Shigella vaginitis and review of literature
  1. Melanie L Gershman1 and
  2. Judith Simms-Cendan2
  1. 1University of Miami Miller School of Medicine, Miami, Florida, USA
  2. 2Obstetrics & Gynecology, University of Miami Miller School of Medicine, Miami, Florida, USA
  1. Correspondence to Melanie L Gershman; mlg75{at}


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.

  • Travel medicine
  • Obstetrics and gynaecology
  • Paediatrics
  • Vulvovaginal disorders

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  • Contributors MG and JS-C contributed to the analysis of the results and to the writing of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.