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Family Practice Aug 1996This study aims to examine the aetiology, clinical features and response to treatment of childhood vulvovaginitis in general practice.
OBJECTIVE
This study aims to examine the aetiology, clinical features and response to treatment of childhood vulvovaginitis in general practice.
METHOD
A longitudinal survey of consecutive premenarchal patients presenting with vulvovaginitis and/or vaginal discharge in the course of normal consultations with a general practitioner was conducted in a semi-rural, group general practice with 11,000 patients in Plymouth, UK. Forty-two premenarchal girls with vaginal inflammation or discharge were surveyed, with main outcome measures being clinical evaluation, microbiological assessment of urine and vaginal swabs, and patients' and parents' assessments of resolution and relapse of symptoms.
RESULTS
Non-specific vulvovaginitis with mixed bacterial flora, associated with poor hygiene and atrophic vaginal mucosa, was the commonest cause; specific bacteria were found in 10 out of 42 cases, including six of Streptococcus pyogenes. No candida was isolated. Treatment with topical oestrogen cream was effective only with mixed infection, oral antibiotics were effective in both mixed and single organisms. No evidence of sexual abuse nor foreign body was found.
CONCLUSION
Childhood vulvovaginitis is not uncommon in general practice, is usually associated with mixed growth of faecal organisms, and is seldom due to serious causes such as sexual abuse or foreign body.
Topics: Case Management; Child; Child Abuse, Sexual; Child, Preschool; England; Female; Follow-Up Studies; Humans; Longitudinal Studies; Primary Health Care; Treatment Outcome; Vulvovaginitis
PubMed: 8872094
DOI: 10.1093/fampra/13.4.369 -
Pediatric Emergency Care Aug 2006
Topics: Child, Preschool; Enterobacteriaceae Infections; Female; Humans; Shigella flexneri; Vulvovaginitis
PubMed: 16912629
DOI: 10.1097/01.pec.0000230707.58775.39 -
Harefuah Jul 2022Vulvovaginitis and labial adhesion are the most common gynecological morbidity among girls and adolescents. Even though pediatricians or family physicians should be... (Review)
Review
Vulvovaginitis and labial adhesion are the most common gynecological morbidity among girls and adolescents. Even though pediatricians or family physicians should be capable of dealing with these "ailments", in Israel, these patients are referred to gynecologists because physicians from these two medical specialties are deterred to treat these populations. Treatment is based on softening and antibiotic creams applied locally. In the current relevant literature the present notion regarding these two pathologies is shifted toward follow-up and habit changes in terms of proper hygiene and clothing. In the present review the relevant current literature is examined and updated recommendations are suggested.
Topics: Adolescent; Anti-Bacterial Agents; Child; Female; Gynecology; Humans; Israel; Vulvar Diseases; Vulvovaginitis
PubMed: 35833429
DOI: No ID Found -
Pediatrics Aug 1982Fifty-four premenarcheal patients (median age 5.8 years) with symptoms or signs of vulvovaginitis were studied, and the results of cultures of vaginal secretions were...
Fifty-four premenarcheal patients (median age 5.8 years) with symptoms or signs of vulvovaginitis were studied, and the results of cultures of vaginal secretions were compared with those from an age-matched control group. Vaginal discharge was found on examination in 24 of 42 patients with a complaint of discharge, and in two of 12 patients without a complaint of discharge. Convincing evidence of bacterial or monilial infection was found in 14 of the 26 patients with discharge on examination, but in none of the 28 patients without discharge (P less than .001). In the latter group pinworm infestation was present in one patient. Moniliasis occurred exclusively in girls who were pubertal (P less than .001). Four patients were found to have gonorrhea. No patient appeared to have symptoms or signs caused by Bacteroides sp, Chlamydia trachomatis, viruses, or Trichomonas vaginalis. Noninfectious causes were identified in four patients with and 13 without discharge (P less than .025); the most common cause was poor hygiene, implicated in six patients. Bubble bath use was implicated in only one patient. In 22 patients, no specific cause could be identified. All patients with poor hygiene as the only cause, and most with no demonstrable etiology, recovered after being advised to institute improved perineal hygiene. Patients with vaginal discharge are likely to have specific infections, and therefore cultures should be taken, in particular for Neisseria gonorrhoeae. Genital pruritus in prepubertal girls has little or no etiologic specificity, but in pubertal girls with vaginal discharge it suggests the presence of monilial vaginitis.
Topics: Bacteria; Bacteroides; Child; Child, Preschool; Chlamydia trachomatis; Female; Humans; Puberty; Vulvovaginitis; Yeasts
PubMed: 7099784
DOI: No ID Found -
Pediatrics Jul 1975Although previous reports have implicated Shigella flexneri in resistant or chronic cases of vulvovaginitis in children, no authors have described the clinical findings...
Although previous reports have implicated Shigella flexneri in resistant or chronic cases of vulvovaginitis in children, no authors have described the clinical findings of this condition. The report presents four cases of persistent vulvovaginitis in prepubertal Indian girls from different reservation communities in Arizona. S. flexneri was isolated in pure culture from the vaginal discharge of each patient. All four cases were characterized by a prolonged vaginitis with a bloody, purulent discharge which responded poorly or not at all to various topical modes of therapy for nonspecific vaginitis. Three cases cleared completely when treated with orally given ampicillin for one week. The striking similarity of these cases suggests that chronic Shigella vulvovaginitis is a recognizable clinical entity and should be considered in the differential diagnosis of persistent vaginitis in children, especially in those from communities where Shigella is endemic.
Topics: Ampicillin; Arizona; Child; Child, Preschool; Enterobacteriaceae Infections; Estrogens; Female; Humans; Indians, North American; Nitrofurantoin; Nystatin; Shigella flexneri; Sulfisoxazole; Sulfonamides; Vulvovaginitis
PubMed: 1098002
DOI: No ID Found -
The Australasian Journal of Dermatology Feb 2018Oestrogen hypersensitivity vulvovaginitis is a rare chronic cyclical vulvovaginitis responsive to oestrogen suppression or antagonism. We present a case series of 16...
Oestrogen hypersensitivity vulvovaginitis is a rare chronic cyclical vulvovaginitis responsive to oestrogen suppression or antagonism. We present a case series of 16 patients with refractory cyclical vulvovaginitis, all of whom responded to oestrogen suppression with cyproterone acetate.
Topics: Adult; Chronic Disease; Cyproterone Acetate; Estrogen Antagonists; Estrogens; Female; Humans; Hypersensitivity; Middle Aged; Vulvovaginitis; Young Adult
PubMed: 28718897
DOI: 10.1111/ajd.12657 -
European Journal of Pediatrics Feb 2004Vulvovaginitis is the most common gynaecological problem in prepubertal girls and clear-cut data on the microbial aetiology of moderate to severe infections are lacking....
UNLABELLED
Vulvovaginitis is the most common gynaecological problem in prepubertal girls and clear-cut data on the microbial aetiology of moderate to severe infections are lacking. Many microorganisms have been reported in several studies, but frequently the paediatrician does not know the pathogenic significance of an isolate reported in vaginal specimens of girls with vulvovaginitis. A multicentre study was performed, selecting 74 girls aged 2 to 12 years old with a clinical picture of vulvovaginitis and inflammatory cells on Gram stain. All the specimens were cultured following standard microbiological techniques and the paediatricians completed a questionnaire to highlight risk factors after interviewing the parents or tutors. The data were compared with those obtained in a control group of 11 girls without vulvovaginitis attending a clinic. Streptococcus pyogenesand Haemophilus spp.were isolated in 47 and 12 cases, respectively. Upper respiratory infection in the previous month ( P<0.001) and vulvovaginitis in the previous year ( P<0.05) were identified as significant risk factors. Foreign bodies, sexual abuse, poor hygiene and bad socioeconomic situation were not identified as risk factors for the infection.
CONCLUSION
Paediatric inflammatory vulvovaginitis is mainly caused by pathogens of the upper respiratory tract and the most common risk factor for this infection is to have suffered an upper respiratory tract infection in the previous month.
Topics: Cells, Cultured; Child; Child, Preschool; Female; Humans; Infant; Respiratory Tract Infections; Risk Factors; Surveys and Questionnaires; Vulvovaginitis
PubMed: 14655013
DOI: 10.1007/s00431-003-1373-x -
American Family Physician Sep 2000Vaginitis is the most common gynecologic diagnosis in the primary care setting. In approximately 90 percent of affected women, this condition occurs secondary to... (Review)
Review
Vaginitis is the most common gynecologic diagnosis in the primary care setting. In approximately 90 percent of affected women, this condition occurs secondary to bacterial vaginosis, vulvovaginal candidiasis or trichomoniasis. Vaginitis develops when the vaginal flora has been altered by introduction of a pathogen or by changes in the vaginal environment that allow pathogens to proliferate. The evaluation of vaginitis requires a directed history and physical examination, with focus on the site of involvement and the characteristics of the vaginal discharge. The laboratory evaluation includes microscopic examination of a saline wet-mount preparation and a potassium hydroxide preparation, a litmus test for the pH of vaginal secretions and a "whiff" test. Metronidazole is the primary treatment for bacterial vaginosis and trichomoniasis. Topical antifungal agents are the first-line treatments for candidal vaginitis.
Topics: Antifungal Agents; Candidiasis; Decision Trees; Diagnosis, Differential; Female; Humans; Trichomonas Vaginitis; Vaginitis; Vaginosis, Bacterial; Vulvovaginitis
PubMed: 10997533
DOI: No ID Found -
The Journal of the Kentucky Medical... Mar 1973
Topics: Age Factors; Child; Female; Foreign Bodies; Humans; Vulvovaginitis
PubMed: 4688935
DOI: No ID Found -
Biomedica : Revista Del Instituto... Aug 2022Proteases and phospholipases are virulence factors of Candida spp. that play an important role in tissue invasion. Among the factors related to the host some are...
INTRODUCTION
Proteases and phospholipases are virulence factors of Candida spp. that play an important role in tissue invasion. Among the factors related to the host some are associated with environmental characteristics and others with Candida colonization.
OBJECTIVES
To determine phospholipase and protease activities in colonizing and pathogenic strains, isolated from pregnant women in Cartagena de Indias.
MATERIALS AND METHODS
Phospholipase and protease activity was determined in 56 isolates, evaluating substrate degradation and calculating the enzyme activity coefficient. Phospholipase and protease activities were compared between colonizing and pathogenic strains.
RESULTS
“Very high” (<0.69) phospholipase and protease activity was found in 34 and 14 isolates, respectively. There was no significant difference when comparing phospholipase and protease activities between colonizing and pathogenic isolates.
CONCLUSIONS
Phospholipase activity predominated as a virulence factor in the studied strains, but no significant difference found between colonizing and pathogenic strains for phospholipase and protease activities.
Topics: Female; Humans; Candida; Vulvovaginitis
PubMed: 37721921
DOI: 10.7705/biomedica.6759