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[Vulvo-vaginitis in pediatric age]
S Beolchi1, C Brambilla, P Roberti
1Divisione di Ostetricia e Ginecologia, Ospedale Vittore Buzzi, Milano.
Insights
Microscopic examination combined with bacteriological analysis improves the diagnosis of pediatric vulvo-vaginitis. This combined approach accurately identifies infections, guiding appropriate treatment for young patients.
Area of Science:
- Pediatric Gynecology
- Infectious Diseases
Background:
- Vulvo-vaginitis is common in pediatric gynecology.
- Diagnosis is challenging due to non-specific symptoms like itching and pain, and signs such as leucoxanthorrhea.
Purpose of the Study:
- To evaluate the diagnostic utility of bacteriological and microscopical examinations for non-specific vulvo-vaginitis in pediatric patients.
- To determine the most effective diagnostic strategy for accurate treatment guidance.
Main Methods:
- Analysis of 215 cases of non-specific vulvo-vaginitis at Vittore Buzzi Hospital's pediatric gynecology clinic.
- Comparison of results from bacteriological examination of vaginal secretions (vaginal tampon) and microscopical examination.
Main Results:
- Vaginal tampon tests were positive in 47% of cases and negative in 53%.
- Microscopical examination demonstrated high sensitivity (81.8%) and specificity (77.4%).
- Bacteriological tests showed a lower positive predictive value (62.2%) due to in vitro growth of opportunistic germs.
Conclusions:
- Microscopical examination is crucial for identifying all cases requiring treatment.
- Bacteriological examination is essential for selecting the correct therapy.
- Combining both microscopical and bacteriological examinations offers a more accurate diagnostic approach for pediatric vulvo-vaginitis.
Abstract:
In pediatric gynecology, inflammatory vulvo-vaginitis are very common. Their diagnosis cannot be based either on the symptoms (itching or pain) or on the signs (leucoxanthorrhea) for these classifications are "non-specific". At the Consulting Room of pediatric gynecology of the Vittore Buzzi Hospital, 215 "non-specific" vulvo-vaginitis cases have been analyzed through bacteriological and microscopical examinations of vaginal secretions. The vaginal tampon resulted negative in 53% of the cases and positive in the remaining 47%. Comparing these results with microscopical examinations we obtain: 81.8% of sensibility, 77.4% of specificity, 87.8% of negative predictive value and 62.2% of positive predictive value. In particular, this last figure is influenced by the high number of false positives of the vaginal tampons, due to the growth "in vitro" of opportunist germs momentarily quiescent "in vivo". Thus it is useful to associated the microscopical examination (that will indicate all the cases in need of treatment) and the bacteriological examination (that will indicate the right cure).