Vulvovaginitis in prepubertal girls: the importance of group A Streptococcus

We report four cases of group A streptococcal vulvovaginitis in prepubertal children. All cases were acute in onset. This illness presents with nonspecific signs and symptoms of labial inflammation. In a suburban community, streptococcal vulvovaginitis in prepubescent girls may be more common then genital infections due to Neisseria gonorrhoeae. Since media used for the selective isolation of N gonorrhoeae do not readily support the growth of streptococci, we suggest that the routine bacteriologic approach to the diagnosis of vulvovaginitis in young girls include inoculation of the culture swab on 5% sheep blood agar and the application of a bacitracin disk (taxo A disc) to detect any small beta-hemolytic, presumptively group A streptococcal colonies after overnight incubation. Penicillin therapy results in prompt cure.