Gonorrheal disease among children in a university hospital.

In the current veneral disease epidemic the pediatrician may observe every clinical expression of gonococcal infection. Review of outpatient records at the University of Maryland Pediatric Clinic (Baltimore, Md.) showed frequent utilization of this health-care facility by girls with genitourinary complaints and a high rate of recovery of Neisseria gonorrhoeae from those patients from whom specimens were obtained for culture. The adolescent girl is the most likely pediatric patient to have genitourinary complaints that indicate a diagnosis of gonorrhea. Overall, 16.3% of girls and 37.2% of boys who had speciments cultured for N. gonorrhoeae had positive results. Although the older teenager (15--18 years of age) was most likely to have a positive culture, high rates comparable to those reported in venereal disease clinics were found for all age groups. Half of the cases of gonorrhea in girls aged 15 to 18 years took the clinical form of pelvic inflammatory disease. Most gonococcal infections in prepubertal children were in girls 2 to 5 years of age and resulted from presumed sexual abuse. Vulvovaginitis was the initial symptom in all cases. Prepubertal boys infected with N. gonorrhoeae all had urethritis; three of seven admitted to voluntary sexual activity.