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Vulvovaginitis

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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

  1. Paladine HL, Desai UA. Vaginitis: Diagnosis and Treatment. Am Fam Physician. 2018 Mar 1;97(5):321-329.

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