Vulvovaginitis in Children and Adolescents

Abstract

Vulvovaginitis is a common problem among both prepubertal and adolescent girls. Since the approach to the examination, the etiology of the vaginal discharge, and the treatment are quite different in the two age groups, this article is divided into two major sections: vaginal discharge in the prepubertal child and vaginal discharge in the adolescent.VAGINAL DISCHARGE IN PREPUBERTAL CHILDThe proximity of the vagina to the anus and the thin uncornified vaginal mucosa make the young child particularly susceptible to vulvovaginal infections with a mixed bacterial flora. Not only is perineal hygiene often inadequate in this age group, especially among overweight girls, but bubblebaths, harsh soaps, close-fitting pants, and nylon tights all contribute to vulvar irritation. Anal scratching associated with pinworm infestations may contaminate the vaginal area with a variety of bowel flora; rarely an adult pinworm may find its way into the vagina. A vaginal discharge may also occur with systemic infections such as measles, scarlet fever and chicken pox. Young girls frequently have redness and irritation for several days; these conditions disappear with the application of a bland ointment and warm baths.Ths history of vulvovaginitis may include complaints of itching, discharge, dysuria, or redness. It is important to elicit the quantity, color, and duration of the discharge, perineal hygiene, use of medication and soaps, symptoms of anal pruritus, and recent infections in the child or the family.