PEDIATRICS Vol. 89 No. 1 January 1992, pp. 149-151
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Repeated, Childhood Vaginal Bleeding Is Not Always Precocious Puberty

JACK A. YANOVSKI MD, PHD1, LAWRENCE M. NELSON MD1, ENGLISH D. WILLIS MD2, and GORDON B. CUTLER JR MD1

1 Developmental Endocrinology Branch, National Institute of Child Health and Human Development
2 The Children's Hospital of Philadelphia

Vaginal bleeding is an uncommon problem in childhood. In infants and children, vaginal bleeding may result from the hormonal fluctuations of precocious puberty.1-4 However, many cases are related to local vaginal problems. We report a case of recurrent vaginal bleeding caused by infection with Shigella flexneri that was difficult to diagnose and treat. This patient was considered by her general pediatrician possibly to have precocious puberty because of her repeated episodes of bleeding.

CASE REPORT

The patient was a 2-year-old Peruvian girl who was suffering from severe nonbloody, nonpurulent diarrhea when she met her adoptive parents in July 1989. The diarrhea persisted for almost 2 months, and although stool cultures in Peru were unrevealing, she was treated with 10-day courses of both trimethoprim-sulfamethoxazole and metronidazole.

Submitted on August 7, 1990
Accepted on January 30, 1991