**5. Sexual abuse and bacterial sexually transmitted diseases in pediatrics**

Sexual abuse should be considered a cause of chlamydial infection among infants and children. Important note: Perinatally transmitted C. trachomatis infection of the nasopharynx, urogenital tract, and rectum can persist for 2–3 years, which is also the most frequent cause of Ng infection in infants and children. If vaginitis is present in preadolescent girls, Ng must be suspected. Nevertheless, pelvic inflammatory disease is less common after vaginal infection in preadolescents. With this finding, Ng must be suspected and tested. Anorectal and pharyngeal infections with Ng in children are frequently asymptomatic; if suspected, samples from these sites must be tested.

Infants and children aged ≥1 month with primary, secondary, or latent syphilis need interdisciplinary treatment including a general pediatrician, a pediatric infectious disease specialist, pediatric psychologist, and social work, which must be evaluated for sexual abuse, and child protective services must be alerted based on local laws.

In the adolescent population, survivors of sexual assault must be examined by experienced clinicians, the obtention of genital or other specimens has to be decided individually and in accordance with local laws. Tv, Ng, and CT are the most common diagnosed pathogens. NAATs for CT and Ng at the site of penetration and for Tv in


*Bacterial Sexually Transmitted Infections - New Findings, Diagnosis,Treatment, and Prevention*


*Sexually Transmitted Diseases in Pediatrics DOI: http://dx.doi.org/10.5772/intechopen.107991*


**34**

*Treatment for the patient and sexual partners per pathogen with some highlights.* *Sexually Transmitted Diseases in Pediatrics DOI: http://dx.doi.org/10.5772/intechopen.107991*

urine or vaginal specimen are recommended. Empiric antimicrobial regimens must be started, for women must include Ceftriaxone 500 mg IM in a single dose, Doxycycline 100 mg two times per day orally for 7 days and metronidazole 500 mg two times per day orally for 7 days. In men, ceftriaxone and doxycycline are recommended with the same doses than women. For persons weighing ≥150 kg, 1 g of ceftriaxone should be administered.

In children, the most important factors that must lead a clinician to evaluate sexually transmitted diseases due to sexual abuse include evidence of penetration or healed penetrative injury to the genitals, anus, or oropharynx, abuse is reported, the child has a relative or another person in his/her same environment with a sexually transmitted disease, signs or symptoms such as vaginal discharge or pain, genital itching or odor, urinary symptoms, or genital lesions or ulcers.
