Differential Diagnosis for Mucous Vaginal Discharge in a Newborn
Single Most Likely Diagnosis
- Vaginal discharge due to maternal estrogen exposure: This is the most common cause of vaginal discharge in newborns, resulting from the exposure to maternal estrogen in utero. The discharge is usually mucoid and can be bloody.
Other Likely Diagnoses
- Physiologic vaginal discharge: Newborns may have a normal, physiologic vaginal discharge that is clear or white, which resolves on its own.
- Infection (e.g., bacterial vaginosis, yeast infection): Although less common in newborns, infections can cause vaginal discharge and should be considered, especially if the discharge is foul-smelling or accompanied by other symptoms.
Do Not Miss Diagnoses
- Sexual abuse: Although rare, sexual abuse must be considered in any case of vaginal discharge or bleeding in a newborn, as it can have severe physical and psychological consequences if missed.
- Congenital anomalies of the reproductive tract: Conditions such as imperforate hymen or vaginal septum can cause vaginal discharge or bleeding and require prompt medical attention.
Rare Diagnoses
- Tumor (e.g., sarcoma botryoides): Rare tumors can cause vaginal discharge or bleeding in newborns and should be considered if other causes have been ruled out.
- Endocrine disorders (e.g., precocious puberty): Certain endocrine disorders can cause vaginal discharge or bleeding in newborns, although these conditions are extremely rare at this age.