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Vulvovaginitis in prepubertal girls
T Stricker1, F Navratil, F H Sennhauser
1University Chidren's Hospital, Zurich, Switzerland. Tamar.Stricker@kispi.unizh.ch
Archives of Disease in Childhood
|March 26, 2003
Summary
In prepubertal girls with vulvovaginitis, pathogenic bacteria were found in 36%, with Group A Streptococcus being the most common. Treatment decisions for vulvovaginitis should rely on bacterial cultures, not just leucocyte presence.
Area of Science:
- Pediatrics
- Infectious Diseases
- Gynecology
Background:
- Vulvovaginitis is common in prepubertal girls, often causing discomfort and parental concern.
- Accurate diagnosis is crucial for appropriate treatment and to prevent complications.
Purpose of the Study:
- To evaluate clinical features and microbiological findings in prepubertal girls with vulvovaginitis.
- To determine the utility of leucocyte presence in vaginal secretions as an indicator of pathogenic bacterial growth.
Main Methods:
- Retrospective study of 80 prepubertal girls (aged 2-12 years) with vulvovaginitis.
- Vaginal secretions collected via sterile catheter for bacterial culture and microscopic examination.
- Analysis of pathogen isolation rates and the diagnostic accuracy of leucocytes.
Main Results:
- Pathogenic bacteria isolated in 36% of cases; Group A beta-hemolytic streptococcus was the most frequent pathogen (59% of positive cultures).
- Candida was not detected in any patient.
- Leucocyte presence showed 83% sensitivity but only 59% specificity for detecting pathogenic bacteria.
Conclusions:
- Bacteriological findings from vaginal secretions are essential for guiding antimicrobial therapy in prepubertal vulvovaginitis.
- Relying solely on leucocyte presence for treatment decisions may lead to inappropriate management.