Pharyngeal gonorrhea in young children

Abstract

Among 16,100 visits to a pediatric clinic, 103 children (0.6%) fulfilled criteria for child abuse and 16 of the 103 patients (15.5%) suffered sexual abuse. Throat cultures from 13 children were positive for Neisseria gonorrhoeae in 7 patients (54%). Ages of infected children ranged from 2.5 to 9 years with a mean age of 4.9 years. N. gonorrhoeae was also isolated from cervical (four) and rectal (one) cultures in four of seven patients tested. No child had symptoms related to the oropharynx. All children were treated with a single dose of 100,000 units aqueous procaine penicillin G per kg intramuscularly and 25 mg probenecid per kg orally. Three of the seven children required retreatment for persistently positive pharyngeal cultures. All cases could be traced to sexual abuse by a male contact. Routine culturing of the oropharynx for N. gonorrhoeae in abused children and their siblings may uncover some unsuspected sexual abuse cases.