Abstract
Objective
Anogenital herpes simplex virus (HSV) is most commonly acquired via sexual transmission
although other nonsexual modes of transmission have been proposed. When a child presents
with a first-time outbreak of anogenital HSV, providers must consider sexual abuse.
There are currently no evidence-based consensus guidelines to inform management of
these patients. The purpose of this study is to describe how child abuse pediatricians
(CAP) evaluate children with anogenital HSV infection and determine whether any consistent
practice patterns are followed.
Participants and setting
Patients included in this study were children between the ages of 0 and 12 years with
a first-time outbreak of anogenital HSV who were medically evaluated by a CAP.
Methods
Patient charts were retroactively reviewed for the period of January 1, 2004 and May
1, 2020.
Results
Twenty-two cases were referred for evaluation by CAP in the chosen time frame. Fifteen
were seen in person. Ten of these patients were interviewed, 15 had an anogenital
exam with colposcopy, and 14 were tested for at least one other sexually transmitted
infection. A diagnosis of sexual abuse was made for 1 patient.
Conclusions
This study demonstrates that while non-sexual transmission of anogenital HSV may be
possible, providers must still consider sexual abuse. Children with a first-time outbreak
of anogenital HSV should have a comprehensive evaluation for sexual abuse including
interview, physical exam, and testing for sexually transmitted infections. Evidence-based
concerns for sexual abuse should be reported to child protective services.
Keywords
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Article info
Publication history
Accepted:
January 13,
2023
Received:
December 5,
2022
Publication stage
In Press Journal Pre-ProofFootnotes
Presented at:
2022 Ray E Helfer Society Annual Meeting, Sponsored by the Ray E Helfer Society, San Diego, CA, April 10, 2022 - April 13, 2022
Identification
Copyright
© 2023 Published by Elsevier Inc. on behalf of North American Society for Pediatric and Adolescent Gynecology.
