Obstet Gynecol Sci.  2016 Mar;59(2):130-136. 10.5468/ogs.2016.59.2.130.

Clinical and microbiologic characteristics of vulvovaginitis in Korean prepubertal girls, 2009-2014: a single center experience

• Kim H
• Chai SM
• Ahn EH
• Lee MH

• KMID: 2159008
• DOI: http://doi.org/10.5468/ogs.2016.59.2.130

Abstract

OBJECTIVE
To update information on the clinical and microbiologic characteristics of pediatric vulvovaginitis in Korean prepubertal girls.
METHODS
A total of 120 girls (aged 0 to 9 years) with culture-confirmed pediatric vulvovaginitis, diagnosed between 2009 and 2014, were enrolled in the study. The epidemiologic and microbiologic characteristics, and clinical outcomes were assessed. Patients with sexual precocity, as well as those who were referred for suspected sexual abuse, were excluded.
RESULTS
Girls aged 4 to 6 years were at the highest risk of pediatric vulvovaginitis. Seasonal distribution indicated obvious peaks in summer and winter. Of the 120 subjects, specific pathogens were identified in the genital specimens in only 20 cases (16.7%). Streptococcus pyogenes (n=12, 60%) was the leading cause of specific vulvovaginitis. Haemophilus influenzae was isolated in one patient. No cases presented with enteric pathogens, such as Shigella or Yersinia. A history of recent upper respiratory tract infection, swimming, and bubble bath use was reported in 37.5%, 15.8%, and 10.0% of patients, respectively. Recent upper respiratory tract infection was not significantly correlated with the detection of respiratory pathogens in genital specimens (P>0.05). Of 104 patients who underwent perineal hygienic care, 80 (76.9%) showed improvement of symptoms without antibiotic treatment. Furthermore, the efficacy of hygienic care was not significantly different between patients with or without specific pathogens (P>0.05).
CONCLUSION
Specific pathogens were only found in 16.7% of pediatric vulvovaginitis cases. Our results indicate an excellent outcome with hygienic care, irrespective of the presence of specific pathogens.

Keyword

Childhood; Hygienic care; Vaginal flora; Vulvitis; Vulvovaginitis

MeSH Terms

Baths
Female*
Haemophilus influenzae
Humans
Respiratory Tract Infections
Seasons
Sex Offenses
Shigella
Streptococcus pyogenes
Swimming
Vulvitis
Vulvovaginitis*
Yersinia

Figure

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  Fig. 1 Age distribution of study participants (n=120).

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  Fig. 2 Seasonal distribution of (A) presentation to clinic, and (B) time of symptom onset in prepubertal girls with vulvovaginitis (n=120).

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  Fig. 3 Seasonal distribution of genital microorganisms in prepubertal girls with vulvovaginitis (n=116a)). a)Of the 120 study participants, 4 patients who presented with Chlamydia trachomatis (n=2), Candida albicans (n=1), and pinworms (n=1) were excluded.

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