Streptococcal Vulvovaginitis Research Articles

A rare case of recurrent group A streptococcal vulvovaginitis in a premenopausal woman.

A rare case of recurrent group A streptococcal vulvovaginitis in a premenopausal woman.

Vulvovaginite streptococcica

The paper describes the case of streptococcal vulvovaginitis with apparently rectal bleeding.

Streptococcus pyogenes as the cause of vulvovaginitis and balanitis in children.

Streptococcus pyogenes (group A Streptococcus) is the etiological agent of perineal infection in children, consisting of perianal infection, vulvovaginitis and balanitis. If it is not properly diagnosed and treated, it can persist for many months and can cause severe complications. Furthermore, treatment with penicillin can be followed by failures and recurrences. We report here the prevalence of S. pyogenes isolates in genital tract specimens from girls (n = 1692) with symptoms of vulvovaginitis and from boys (n = 52) with balanitis in the municipality of Nis, Southeast-Serbia (the Western Balkans) in a 10 year period, and the seasonal distribution, patient age and sensitivity to bacitracin and antimicrobial drugs used in the treatment of streptococcal infection. Streptococcal vulvovaginitis was diagnosed in 2.30% of examinees. Of those cases, 64.10% were detected from April to September, and it was most common (71.79%) in girls aged 3-7 years. Streptococcal balanitis was diagnosed in two instances: in a 4-year-old boy and in a 7-year-old boy. S. pyogenes strains resistant to bacitracin were identified in five girls. Two isolates with M phenotype and five isolates with cMLSB phenotype were identified. Streptococcal vulvovaginitis was diagnosed less often in the present study, but it was still far more common than streptococcal balanitis in childhood. Bacitracin resistance of S. pyogenes strains should be taken into account in routine microbiological identification, and the detection of S. pyogenes isolates resistant to erythromycin requires surveillance in the present geographical territory.

STREPTOCOCCUS PYOGENES AS THE CAUSE OF VULVOVAGINITIS IN ADULT WOMEN

According to the literature data, Streptococcus pyogenes is the most common cause of infectious vulvovaginitis in prepubertal girls, but it is rarely described in adult women. In this paper we report the prevalence of S. pyogenes vulvovaginitis in adult women in the municipality of Nis, Serbia, in a five-year period. The total of 42.259 women with symptoms of vulvovaginal infection were enrolled in the study and their swabs from the vagina and cervix were examined using the standard microbiological procedures: direct microscopy of Gram stained preparations and sample culture. Women with positive S. pyogenes findings were later contacted to give anamnestic data and for post-treatment control examinations. S. pyogenes was isolated from the samples of 2 patients: in July 2012 in a 20-year-old woman with the anamnesis of a previously diagnosed tonsillopharyngitis, and in May 2015 in a 32-year-old breast-feeding woman. These patients had the signs and symptoms of acute inflammation: vaginal and vulvar pain, dyspareunia, burning sensation, pruritus, and a profuse, watery, yellow vaginal discharge. Gram staining revealed abundant segmented WBCs and gram-positive cocci in pairs and chains. After the administered penicillin therapy, the control microbiological examinations of the vaginal and cervical swabs were done, as well as the throat swab culture for the presence of S.pyogenes, and all the results were negative. Streptococcal vulvovaginitis in adult women was diagnosed in only two examinees in our study and was associated with a predisposing factors: personal history of a respiratory infection and lactational vaginal atrophy.

Lactational Amenorrhea as a Risk Factor for Group A Streptococcal Vaginitis

We report a case of Streptococcus pyogenes, beta-hemolytic Streptococcus, Lancefield group A vulvovaginitis in an otherwise healthy adult female patient experiencing lactational amenorrhea. Group A streptococcal infection is the infective cause of vulvovaginitis in 21% of prepubescent girls, but it is an uncommon cause of vulvovaginitis in adults. Group A streptococcal vulvovaginitis is frequently associated with households that have had a recent outbreak of respiratory or dermal infection. The case described here appears to be unusual in that it was sexually transmitted, and the lack of estrogen associated with anovualtion may have been a predisposing factor for this unusual sexually transmitted disease.

Two cases of group A streptococcal vulvovaginitis in premenopausal adults in a sexual health setting

Two cases of group A streptococcus (GAS) causing vulvovaginitis in premenopausal adults are described. A review of the literature of genital GAS is made, as this is an uncommon cause of vulvovaginitis in premenopausal adults. Contrasts are made between anogenital carriage of GAS and group B streptococcus (GBS) to highlight the differences in anogenital carriage between these two organisms.

Vulval disease in pre-pubertal girls.

Children present with vulval complaints less frequently than do adults; although there are many similarities between paediatric and adult groups of patients with vulval disease, there are also important differences. In both groups, dermatitis, psoriasis and lichen sclerosus are the most frequently seen dermatoses. Birthmarks and congenital abnormalities presenting for the first time are more of an issue in children than in adults. Fusion of the labia and streptococcal vulvovaginitis are conditions seen only in the paediatric group. Sexually transmitted diseases such as genital warts and genital herpes are not common in this group and should always raise the possibility of child sexual abuse. Chronic vulvovaginal candidiasis, although a very common problem in adult patients, is not seen in the prepubertal group.

Vulvar disease in children: a clinical audit of 130 cases.

We evaluated 130 prepubertal girls presenting with a vulvar complaint to determine the spectrum and frequency of conditions seen in this age group. Of the patients, 41 (33%) had atopic or irritant dermatitis, 23 (18%) had lichen sclerosus, 21 (17%) had psoriasis, 15 (12%) had vulvar lesions, most often hemangiomas and nevi, and 13 (10%) had streptococcal vulvovaginitis. Diagnoses less frequently seen were staphylococcal folliculitis (four patients), labial fusion (three patients), genital warts (two patients), molluscum contagiosum of the vulva only (one patient), vulvar bullous pemphigoid (two patients), scabies nodules (one patient), erythema annulare centrifugum (one patient), tinea (two patients), and vitiligo (one patient). We also encountered vulvar presentations of systemic diseases (varicella, staphylococcal scalded skin syndrome, and Henoch-Schönlein purpura, all one patient each). We did not see candidal vulvovaginitis in this age group nor did we encounter bacterial infection with pathogens other than Staphylococcus aureus and S. pyogenes.

Recurrent streptococcal vulvovaginitis: A proposed new treatment modality

Recurrent streptococcal vulvovaginitis: A proposed new treatment modality

Group A beta-hemolytic streptococcal vulvovaginitis in prepubertal girls

Vulvovaginitis has been regarded as the most common gynecologic complaint in prepubertal girls by numerous authors.1–6 Group A beta-hemolytic Streptococcus is one of the most frequent etiologic agents of this entity.4,7In this report we present a case of streptococcal vulvovaginitis and review the literature of the past 20 years to highlight the recent signs, symptoms and epidemiology.

Vulvovaginitis in prepubertal girls: the importance of group A Streptococcus.

We report four cases of group A streptococcal vulvovaginitis in prepubertal children. All cases were acute in onset. This illness presents with nonspecific signs and symptoms of labial inflammation. In a suburban community, streptococcal vulvovaginitis in prepubescent girls may be more common then genital infections due to Neisseria gonorrhoeae. Since media used for the selective isolation of N gonorrhoeae do not readily support the growth of streptococci, we suggest that the routine bacteriologic approach to the diagnosis of vulvovaginitis in young girls include inoculation of the culture swab on 5% sheep blood agar and the application of a bacitracin disk (taxo A disc) to detect any small beta-hemolytic, presumptively group A streptococcal colonies after overnight incubation. Penicillin therapy results in prompt cure.

Seasonal variation of streptococcal vulvo-vaginitis in an urban community.

A study was made of patients investigated by general practitioners. Over a three-year period Streptococcus pyogenes (group A) was isolated most commonly from vaginal and vulval swabs collected in the winter. The serotypes of strains indicate that some had probably been derived from the skin and others from the respiratory tract. The two sources are thought to have masked a consistent, but not obvious, seasonal variation in streptococcal vulvo-vaginitis acquired usually from streptococcal infections of the respiratory tract in winter and from those of the skin in summer.