An 11-year-old Austrian girl is said to have been infected with gonorrhea after bathing in a popular thermal pool while on holiday in Italy.
The girl was diagnosed with Neisseria gonorrhoeae after a dive in the hot spring of the island of the crater lake of Pantelleria Specchio di Venere, also known as the “Mirror of Venus”.
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The girl’s case was reported in a study earlier this fall in the Journal of Medical Case Reports.
Two days after her family’s visit to the pool, researchers from New Zealand University of Auckland and Austrian University of Salzburg said the girl had developed vulvovaginitis.
Vulvovaginitis is an inflammation or irritation of the vagina and vulva, and the condition has been partially alleviated by an over-the-counter antifungal cream.
Vaginal lamvae were cultured positive for the bacterial pathogen responsible for gonorrhea, but the child’s family members tested negative.
The report showed the family separated, with her and her father wading into one pool and her mom and younger sister in another.
Because the girl inflexibly denied any sexual contact and no opportunities for sexual exposure could be identified, it was concluded that she had probably gotten the infection from pool water contaminated with gonococcus after a two-day incubation period.
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Subsequently, the infection was successfully treated using ceftriaxone and azithromycin, without adverse effects.
The girl’s pediatrician recommended milk baths for a period of two weeks to help restore her vaginal flora, and vaginal symptoms settled within a few days. A repeat lamp four weeks later was negative.
Experts believe that the temperature of the slightly acidic water served as a possible source of the infection.
The study’s authors said there is a need for a public understanding of the risk of exposure to pathogens by bathing in highly frequented shallow thermal pools.
They suggested adding a sign, shower and antibacterial soap near the hot springs.
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“There are historical case reports in the literature of gonorrhea epidemics in children’s hospitals traced to frequent baths. It is imperative that all cases of gonorrhea infection in children are fully investigated, including examination of all other related family members, to determine whether sexual assault has occurred. that is not a misdiagnosis, ”they wrote. “However, both sexual and asexual transmission is possible. An assumption that a gonorrhea infection is a diagnosis of sexual abuse can be terrible, with children being unfairly removed from the care of their parents and their caregivers facing false accusations of sex crimes.”
“Our case serves to illustrate that the very rare diagnosis of gonorrhea in a child may be the result of asexual transmission of the infection, and that contaminated hot pools are a very rare source of infection to consider,” the authors said.