Forensic investigation of child victim with sexual abuse.

Sexual abuse includes any activity with a child, before the age of legal consent, that is for the sexual gratification of an adult or a significantly older child. Sexual mistreatment of children by family members (incest) and nonrelatives known to the child is the most common type of sexual abuse. Intrafamiliar sexual abuse is difficult to document and manage, because the child must be protected from additional abuse and coercion not to reveal or to deny the abuse, while attempts are made to preserve the family unit. The role of a comprehensive forensic medical examination is of major importance in the full investigation of such cases and the building of an effective prosecution in the court. The protection of the sexually abused child from any additional emotional trauma during the physical examination is of great importance. A brief assessment of the developmental, behavioral, mental and emotional status should also be obtained. The physical examination includes inspection of the whole body with special attention to the mouth, breasts, genitals, perineal region, buttocks and anus. The next concern for the doctor is the collection of biologic evidence, provided that the alleged sexual abuse has occurred within the last 72 hours. Cultures and serologic tests for sexually transmitted diseases are decided by the doctor according to the special circumstances of each case. Pregnancy test should also be performed in each case of a girl in reproductive age.