Vulvovaginitis: causes and management.

Clinical and microbiological features of vulvovaginitis in Mexican girls

“…Signs and symptoms include irritation and erythema of the vulva, vaginal discharge, soreness, itching, dysuria, and bleeding [4][5][6][7]. Vulvovaginitis is generally considered to be the commonest gynecological problem in prepubertal girls [1][2][3]. These girls have several predisposing factors.…”

“…Another risk factor is the poor hygiene. Children are usually careless about hand washing, often slide off toilet seats, wiping from back to front after bowel movements, therefore contaminating the vagina with enteric pathogens, scratching with dirty fingernails and playing in sand [1][2][3][4][5][6][7][8][9]. Other factors include the obesity, hot weather, wearing synthetic underwear, tights, slacks, using perfumed soaps, bubble bath or masturbation can exacerbate the problem [7][8][9][10][11].…”

“…Vulvovaginitis is an inflammation of the vulva and vaginal tissues [1][2][3]. Signs and symptoms include irritation and erythema of the vulva, vaginal discharge, soreness, itching, dysuria, and bleeding [4][5][6][7].…”

“…The anatomical factors include lack of protective labial fat pads or pubic hair, the closeness of the vulva to the anal region, and the labia minor are smaller, do not meet in midline and further tend to open up as the child squats, uncovering the most sensitive tissues within the hymeneal ring [1][2][3][5][6][7][8][9]. The physiological factors accepted consist of the thinness of the vulvar skin and physiological atrophy of the vaginal epithelium, low in glycogen, with neutral pH and nonproduction of cervical mucus and the poor local immune system [1][2][3][4][5][6][7]. All these factors make it a good culture media for the bacteria, which can easily penetrate the thin, vaginal mucosa [10][11][12][13][14].…”

“…A diffusion of bacteria from the upper airways is also possible through auto-inoculation or occasionally hematic spread. Finally, the possibility that vulvovaginitis may be secondary to intravaginal foreign bodies or to sexual abuse must also be borne in mind [1][2][3][4][5][6][7][8][9][10].…”