I'm sorry your daughter is so ill. How horrible for her, and for you. I, like you, am worried about the vaginal spotting. Unfortunately, this could be a sign of a rectovaginal fistula (or, much less common, a colovaginal fistula), in which feces and/or blood can pass from the rectum or the colon into the vagina. At age 10, that might be more likely than starting her period, unless she is a very early developer, and is already showing signs of puberty.