Vulvovaginitis
In children, vaginitis is usually accompanied by secondary vulvitis, and the condition is known as vulvovaginitis.
It is usually associated with:
- poor perianal hygiene - fluff or toilet tissue may accumulate and form a nidus about which debris collects
- insertion of a foreign body by the child
- sexual interference
Infection is relatively uncommon as the non-oestrogenised vagina is protected by the hymen. Organisms that may be responsible include:
- Candida or Trichomonas carried from an adult
- Neisseria gonococcus
- threadworms passing from the anus to the vulva
Soreness and discomfort on micturition are common. A purulent discharge is suggestive of a foreign body.
Management:
- advice on general hygiene where appropriate e.g. wipe from the front to the back; daily washing of the vulva
- vaginal swab and culture
- rectal examination to exclude a foreign body
- oral metronidazole for Trichomonas
- oral nystatin for Candida
Reference
- Paladine HL, Desai UA. Vaginitis: Diagnosis and Treatment. Am Fam Physician. 2018 Mar 1;97(5):321-329.
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