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A 4-year-old girl is brought to the physician by her mother who is concerned because her child has a vaginal discharge. Starting 2 days ago, the child began scratching her vulva and complaining of burning with urination. The child is otherwise healthy and has never had a similar problem. Examination reveals normal structural anatomy for a 4-year-old girl. There is no evidence of atrophy. There is an inflammatory erythema on the medial aspects of the labia majora and excoriations. There is a mucous discharge with a few flecks of blood intermixed. Which of the following is the most likely cause of a vaginal discharge in this patient?

A. Lichen sclerosis
B. Pelvic inflammatory disease
C. Sarcoma botyroides (embryonal rhabdomyosarcoma)
D. Sexual abuse
E. Vaginal foreign body


E. Vaginal foreign body



maybe the 2nd most likely would be D.


D. Sexual abuse


E is given answer due to inflammatory erythema, & mucous discharge, but I still confuse with D

Any more comments ?


i think its E as Kaplan notes also says so.

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