Vaginal purulent discharge in children is mainly due to nonspecific enteric bacterial agents and specific agents such as group A beta-hemolytic streptococcus
, hemophilus influenzae
and Staphylococcus aureus
. Lack of protective effects of estrogen in vaginal mucosa is the main predisposing factor. Persistent or recurrent foul smelling and/or serosanguineous vaginal discharge, not responsive to medical therapy in most cases, might be caused by a missed vaginal foreign body.
We present a 7-year old girl because of persisting foul smelling, occasionally blood stained vaginal discharge for about 4 years despite a few courses of medical therapy by gynecologists. Ultrasonography didn't achieve to demonstrate the presence of the foreign body, but pelvic x-ray showed a radio-opaque body resembling a roll plaque. Vaginoscopy discovered a cap of eyebrow pencil in the upper vagina. This removed by forceps led to improvement of the disease.
In a child presenting with vaginal discharge not responsive to hygienic measures and medical therapy, possibility of vaginal foreign body must be considered. Although MRI is the most proper technique for evaluation, sonography and/or x-ray are more available and helpful in most cases.