Vulvovaginitis in prepubertal girls

Objective: Vulvovaginitis is the most common gynaecological problem in prepubertal girls. Factors that explain the increased susceptibility of children to vulvovaginitis include: the close anatomical proximity of the rectum; lack of labial fat pads, and pubic hair, small labia minora, thin and delicate vulva skin; thin, atrophic anoestrogenic vaginal mucosa, and children‘s tendency to have poor local hygiene and to explore their body.
Aim: The aim of this study was evaluation of the clinical features and findings in bacterial cultures in prepubertal girls with vulvovaginitis.
Materials and Methods: 185 prepubertal girls from 0 to 12 years old, were seen in the outpatient clinic of the Institute of Mother and Child in Warsaw because of vulvovaginitis. The participants of this study were interviewed about their symptoms, disease and during examination vaginal secretions were obtained directly from the vagina with catheter inserted into the vagina. Secretion was cultured onto different agar plates. Antimicrobal treatment should therefore be based on bacteriological findings.
Conclusion: The main symptoms were vaginal discharge (62%) and erythema (56%). E. coli (45%), Streptococci β-hemolitic group A (11%), Enterococci sp. (12%) were the most frequent pathogens involved in the disease. Candida was found in only 4% of cases. Bloody vaginal discharge and recurrent inflammation could be reason of vaginal foreign bodies.