Vulvovaginitis: clinical features, aetiology, and microbiology of the genital tract
A Jaquiery, A Stylianopoulos, G Hogg, S Grover
Alice Springs
Hospital, Alice Springs, NT 0870, Australia
Correspondence to: Dr Jaquiery.
Accepted 15 February 1999
AIM
To clarify the
contribution of clinical and environmental factors and infection to the
aetiology of vulvovaginitis in premenarchal girls, and to determine
clinical indicators of an infectious cause.
DESIGNIt was
necessary first to define normal vaginal flora. Cases were 50 premenarchal girls > 2 years old with symptoms of vulvovaginitis; 50 controls were recruited from girls in the same age group
undergoing minor or elective surgery.
RESULTSInterview
questionnaire showed no difference between cases and controls in
regards to hygiene practices, exposure to specific irritants, or
history of possible sexual abuse. Normal vaginal flora was similar to
that described in previous studies, with the exception of organisms
likely to be associated with sexual activity. 80% of cases had no
evidence of an infectious cause. In the 10 cases in whom an infectious
cause was found, there was significantly more visible discharge and
distinct redness of the genital area on examination compared with other cases.
CONCLUSIONS The
findings suggest that vulvovaginitis in this age group is not usually
infectious or necessarily related to poor hygiene, specific irritants
or sexual abuse, although any of these can present with genital
irritation. The possibility of sexual abuse should always be considered
when a child presents with genital symptoms, but our data indicate it
is not a common contributing factor. Infection is generally associated
with vaginal discharge and moderate or severe inflammation.
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Key messages
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Keywords: vulvovaginitis; premenarchal; vaginal flora
© 1999 by Archives of Disease in Childhood
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