Sexual assault
Posted by dkwinter

In prepubertal girls, swabs should be taken from vaginal vault or just proximal to the hymen as infection in prepubertal girls causes vaginitis not cervicitis
Test for
     HepB, HepC
     N. gonorrhea
     C. trachomatis
     T. vaginalis
Prophylactic abx not required in prepubertal pt due to the low risk of ascending infection and frequent need for confirmatory testing
     HIV and HepB ppx are exceptions
Exam, note:
     Position examined in
     Whether labial traction applied
     Sexual maturity rating
     Position of findings with 12 o'clock at urethra
          Hymenal characteristics including hymenal edge features
               Complete transections
           Pertinent negatives
           Whether photos were taken
Useful exam findings (Berkoff et al., JAMA Dec17, 300:23)
     Presence of vaginal discharge (LR 2.7, CI 1.2-6.0)
     Hymenal opening greater than 6.5mm in the knee chest position (LR 2.0, CI 1.3-3.2)