Herpes infection in two young girls – is it indicative of child sexual abuse?

Genital Herpes in a pre-pubertal child raises the suspicion of sexual abuse. Two 12-year-old girls presented with multiple painful blisters in the genital area. with a history of alleged sexual abuse.  The appearance was very suggestive of herpes infection. Investigations confirmed HSV-1 and HSV-2 infection in the two cases. Presence of herpes without any other positive sexual abuse indicators would make it challenging to prove child sexual abuse. It can also result from non-abusive hand to genital contact. Interpretation of the presence of genital Herpes should be made carefully as it could be challenged at the court of law.