Microbiological aspects of vulvovaginitis in prepubertal girls

Abstract

The microbial ecosystem in girls with clinical signs of vulvovaginitis is complex and variable, and the presence of a microorganism does not necessarily imply that it is the cause of infection. The diagnosis of vulvovaginitis in prepubertal girls requires a complex and comprehensive approach, and microbiological findings should be interpreted in the context of clinical findings.

Personal Hygiene and Vulvovaginitis in Prepubertal Children

“…Such pathogenic microorganisms as β-hemolytic streptococci, H. influenzae, and, S. pneumoniae are frequently responsible for vulvovaginal infections in children (5,(15)(16)(17).…”

“…Also, prepubertal girls lack protective labial fat pads and pubic hair. In addition, one effect of estrogen in puberty is to thicken the vaginal mucosa and thus reduce the incidence of potential infections and vaginitis (2)(3)(4)(5)(6)(7).…”

Clinical Recommendation: Labial Adhesions

“…Although vaginal infection with Neisseria gonorrhea, Gardnerella vaginalis, Chlamydia trachomata, or Trichomona vaginalis in children are less common, they can be etiologies of chronic vulvar inflammation and labial adhesions. 5 Any sexually transmitted infection in this population necessitates consideration of sexual abuse. 5 Genital trauma can also lead to labial adhesions.…”

“…5 Any sexually transmitted infection in this population necessitates consideration of sexual abuse. 5 Genital trauma can also lead to labial adhesions. This can be the result of female circumcision or a straddle-like injury.…”

“…5 Other infectious etiologies predispose to adhesionsdmost commonly group A Streptococcus after a vulvovaginal skin infection. Although vaginal infection with Neisseria gonorrhea, Gardnerella vaginalis, Chlamydia trachomata, or Trichomona vaginalis in children are less common, they can be etiologies of chronic vulvar inflammation and labial adhesions.…”