Microbiological findings of vulvovaginitis in prepubertal girls

Bumbulienė, Žana; Venclavičiūtė, Karolina; Ramašauskaitė, Diana; Arlauskienė, Audronė; Bumbul, Elžbieta; Drąsutienė, Gražina Stanislava

doi:10.1136/postgradmedj-2013-131959

Cited by 29 publications

(24 citation statements)

References 16 publications

(23 reference statements)

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“…Clinically, streptococcal vulvovaginitis is characterized by the signs and symptoms of acute infection: irritation, painful erythematous vulva and vagina, seropurulent and occasionally serosanguinous discharge and dysuria. 15,16 In the present study, all the girls with S. pyogenes infection had clinically manifested inflammatory reaction, and the Gram stain showed a large numbers of PMN leukocytes. In 33 examinees S. pyogenes was the only isolate, while in six examinees Staphylococcus aureus was isolated as well.…”

Section: Discussionsupporting

confidence: 54%

Streptococcus pyogenes as the cause of vulvovaginitis and balanitis in children

Randjelovic

Otasevic

Mladenović-Antić

et al. 2016

Pediatrics International

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Section: Discussionsupporting

confidence: 54%

Streptococcus pyogenes as the cause of vulvovaginitis and balanitis in children

Randjelovic

Otasevic

Mladenović-Antić

et al. 2016

Pediatrics International

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“…6 In a study by Yilmaz et al, pre-pubertal children had a predominant growth of β haemolytic Streptococci. We were able to demonstrate beta haemolytic Streptococci in only two of the subjects studied which is more or less similar to the observation made by others.…”

Section: Discussionmentioning

confidence: 99%

Aetiology of vaginal discharge in children

2017

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Background: Vaginal discharge [VD] is the most common gynecologic complaint in children. The causes vary from being physiological to sexually transmitted diseases. The anatomy and physiology of the vulva and vagina and the vaginal flora influence the causes to some extent. As the above factors vary as the child grows, the etiology varies too. At any age, VD is responsible for a significant morbidity. Hence enumerating the causes and identifying the common causes in specific age groups will help in development of preventive measures and early appropriate treatment. The aim of the study was to enumerate the cause of VD in children attending the OPD at Government Royapettah Hospital and to find out the causes of VD in specific age groups less than 2 year, 2-9 years and 9-14 years.Methods: A retrospective analysis of twenty girls less than 14 years of age with VD details were collected from the STI cards of twenty children in the age group upto 14 years, with vaginal discharge, who attended the STI clinic at GRH, KMC will be selected and their symptoms, clinical examination findings, results of relevant investigations noted from their hospital records. Children with HIV infection, immunosuppression due to juvenile diabetes mellitus/ malignancy and history of sexual abuse will be excluded. The results tabulated and a descriptive analysis done to find out the most common aetiology in different age groups in children. Descriptive analysis was applied to analyse the results.Results: Out of the twenty children studied 40, 10, 50 percent of the girls were in group A, B and C respectively. Youngest child was 6 months old and oldest was 14 years. In 10% of girls the incidence of VD was physiological and in 90% it was due to pathological causes. In 50% of children the causative agent could be demonstrated by laboratory investigations. Candida was the commonest agent demonstrated in 25% of girls studied. In 35% cases the cause was unidentifiable. Bacterial, parasitic and dermatological causes constituted to 10%, 15%, 10% of aetiology of VD respectively. In one child [5%] who had genital psoriasis, the clinical features of candidal infection was negative.Conclusions: Aetiological diagnosis was very important in children with VD. Not all VD in children are infective and hence anti-fungal and anti-bacterial agents should not be prescribed without adequate clinical and or microbiological evidence. Pin worm infestation should be considered as a cause of VD in girls with perianal excoriation and nocturnal worsening of symptoms.

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“… Moreover, small labia minora, the absence of labial fat pads and pubic hair, poor hygiene, and risky behaviors increase the possibility that prepubertal girls will develop vaginitis. Several studies have reported that Streptococcus pyogenes and H. influenzae are the most common causes of juvenile vulvovaginitis . Although Staphylococcus spp., Streptococcus spp., Enterococcus spp., Corynebacteria spp., Enterobacteria spp., Leptothrix spp., Gardnerella vaginalis , Acinetobacter spp.…”

Section: Discussionmentioning

confidence: 99%

“…Because touching of the vulva and even the insertion of foreign bodies into the vagina may occur deliberately during childhood, it is reasonable to postulate that the upper respiratory tract could be a source of vaginal flora for prepubertal girls. Several studies have determined that S. pyogenes and H. influenzae are the most common causes of juvenile vulvovaginitis . Although S. pyogenes and H. influenza are components of the normal flora of the upper respiratory tract, these organisms are common causes of otitis media, pneumonia, rhinitis, and sinusitis in children.…”

Section: Discussionmentioning

confidence: 99%

“…Although this disease is most commonly attributed to poor hygiene or non‐specific irritants, it can be a manifestation of bacterial or pinworm infection or a consequence of anatomical anomalies, antibiotic therapy or the presence of a foreign body . Confirmed bacterial infections have been found in approximately one‐third of girls with vulvovaginitis, and these infections were caused by upper respiratory or intestinal flora . In such cases, it has been assumed that respiratory bacteria were transmitted to the perineal area via the hands, but direct evidence of this conjecture has not been obtained.…”

Section: Introductionmentioning

confidence: 99%

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Haemophilus influenzae vulvovaginitis associated with rhinitis caused by the same clone in a prepubertal girl

Chen

Zhang

et al. 2017

J of Obstet and Gynaecol

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Vulvovaginitis caused by upper respiratory flora is generally considered to be the most common gynecological problem in prepubertal girls. To date, however, no direct evidence has been obtained for the underlying mechanism of transmission. This report describes a case of non-capsulate Haemophilus influenzae vulvovaginitis in a 6-year-old girl with a history of foreign bodies (cotton wool) in her vagina. Moreover, this girl had recurrent rhinitis for approximately 3 years. On Pulsed Field Gel Electrophoresis (PFGE) analysis the H. influenzae strain isolated from vaginal secretions and the H. influenzae strain isolated from nasal secretions were derived from the same clone. The patient was successfully treated with appropriate antibiotics. The present case might provide the first direct evidence of the nose-hand-vagina method of transmission.

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Microbiological findings of vulvovaginitis in prepubertal girls

Abstract: Positive microbiological findings, mixed bacteria cultures and a high growth of bacteria colonies are found significantly more often in girls with vulvovaginitis. The main causative premenarchal vulvovaginitis agents are faecal in origin.

Cited by 29 publications

References 16 publications

Streptococcus pyogenes as the cause of vulvovaginitis and balanitis in children

Streptococcus pyogenes as the cause of vulvovaginitis and balanitis in children

Aetiology of vaginal discharge in children

Haemophilus influenzae vulvovaginitis associated with rhinitis caused by the same clone in a prepubertal girl

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