Sir.—In the February 1990 issue of AJDC, Klevan and DeJong1 reported that from a group of 428 sexual-abuse victims, only 2 were found to have a urinary tract infection (UTI). They concluded correctly that routine screening for UTI is not indicated for all victims of sexual abuse.
More importantly, however, the authors overlooked the pertinent question, specifically whether UTI may be an indicator of sexual abuse. The study design, as with Reinhart's previous study,2 instead measures whether sexual abuse is an indicator of UTI. A similar study of patients with cystic fibrosis, for example, might find on examination that no patient had rectal prolapse, and investigators would conclude that rectal prolapse is not an indicator of cystic fibrosis. A urologist might be interested in answering the question, "If a child presents with sexual abuse, is the child at risk for UTI?" Most clinicians, however, would ask, "If
MEHL AL. Urinary Tract Infection and Sexual Abuse. Am J Dis Child. 1990;144(10):1073–1074. doi:10.1001/archpedi.1990.02150340015009
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