Vulvovaginitis in the preadolescent girl

Vaginal discharges in prepubertal girls can be categorized under two broad headings--those with specific microbiological causes and, in the absence of such, those that are nonspecific in origin. For specific vulvovaginitis, treatment should be tailored to the findings on cultures, wet mounts, KOH, or other slide preparations. For the sexually transmissible organisms resulting in a vaginal discharge, thorough social service investigation should be undertaken in addition to appropriate antibiotic therapy. When a microbiological cause cannot be found and a foreign body has been ruled out, one is left with a diagnosis of nonspecific vulvovaginitis; treatment goals should be aimed at reassuring and re-educating the patient and parents in good hygienic practices as well as the elimination of potential irritants.