Acquired rectovaginal fistula in human immunodeficiency virus-positive children

In 1990, at Harare Central Hospital, an unusual finding of acute acquired rectovaginal fistula, principally in young infants, was noted. These infants had a normal anorectal canal and most had a history of passing stool through the vagina for 1 to 2 months. PRESENTATION The first infant was seen in 1990 and both mother and child had evidence of acquired immunodeficiency syndrome (AIDS). Since then 17 girls have been admitted to the Pediatric Surgical Service with the same complaint, but no other mother has had obvious AIDS. All but one infant, who died of clinical AIDS before a test was obtained, were human immunodeficiency virus (HIV)-positive as determined by an enzyme-linked immunosorbent assay (ELISA) test.