Uganda, Nov. 29 -- Louisa* sounded very anxious on the phone. She was calling to schedule an emergency appointment for her 10-year old daughter Lavinia* on short notice.
They came in at 4 o'clock and while the mother was visibly concerned, Lavinia was only upset at having missed her swimming practice.
That morning, Lavinia had reported a discharge from the vulvovaginal area, which had soiled her underwear. She showed this to her mother before she took her morning shower. Now, Louisa was here for answers. Her biggest concern was that Lavinia may have been sexually assaulted.
A thorough history and physical exam revealed a mildly inflamed vaginal opening with yellowish-creamish vaginal discharge, but with otherwise normal external genitals...