STIs should be suspected in teen girls presenting to ED with abdominal pain

Teenaged girls who go to the emergency department (ED) with symptoms predominately of lower abdominal pain or genitourinary complaints should be tested for sexually transmitted infections (STIs), according to a study presented at the 2011 Pediatric Academic Societies annual meeting in Denver.

Past studies indicate that female adolescents with symptoms suggestive of STIs are not always tested for STIs. Part of the reason for lack of testing is because this subject has been understudied and therefore practitioners are not aware of STI risk in this group.

Researchers from Children’s Hospital of Philadelphia conducted a prospective prevalence study of 236 adolescent females aged 14 to 19 years who presented to a pediatric ED with symptoms suggestive of an STI and who were tested for 3 common STIs: Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis. Symptoms included lower abdominal, pelvic, or flank pain and/or genitourinary complaints. Descriptive statistics and logistic regression also were performed.

Among girls tested, 26.3% were found to have an STI-19.7% had chlamydia, 9.9% trichomonas, and 3.5% gonorrhea. Of those with chlamydia, 19% also had trichomonas, and 6.7% were infected with both chlamydia and gonorrhea. A logistic regression found a significant link between STI and black race (odds ratio [OR], 15.2) and no private insurance (OR, 3.14). There was no significant association between STI and age or primary complaint.

Considering the high prevalence of STIs in this population, adolescent females presenting to the ED with lower abdominal symptoms should be assessed for STI risk, the researchers advise.

Goyal M, Hayes K, Mollen C. Prevalence of sexually transmitted infections in symptomatic adolescent females in a pediatric emergency department. Paper presented at: Pediatric Academic Societies and Asian Society of Pediatric Research Joint Meeting; April 30-May 2, 2011; Denver, CO. Abstract 1675.1.