Clinical Symptoms and Microbiological Findings in Prepubescent Girls with Vulvovaginitis

J Pediatr Adolesc Gynecol. 2022 Dec;35(6):629-633. doi: 10.1016/j.jpag.2022.07.005. Epub 2022 Jul 9.

Abstract

Background: The diagnosis and treatment of vulvovaginitis in children is poorly managed because it is difficult to determine whether the agent causing vulvovaginal inflammation is a single bacterial species.

Study objective: This study retrospectively evaluated genital microbiological findings in prepubescent girls with vulvovaginitis and then compared the findings to healthy controls without discharge.

Methods: This was a retrospective case-control study of 483 prepubescent girls aged 2-10 years with vulvovaginitis and 50 age-matched healthy asymptomatic controls. Data were collected at the Pediatric General Outpatient Unit of the Hospital of the Bezmialem Vakıf University from December 2015 to March 2021.

Results: Of the 483 positive vaginal cultures in the study group, 248 (51.3%) exhibited potential causative agents. Conversely, 8 of 50 (16%) of the vaginal cultures in the control group (P < .001) exhibited potential causative agents. Streptococcus pyogenes was the most frequently detected causative agent of vulvovaginitis in the study group. S. pyogenes was present in specimens from 74 girls (15.8%) with symptoms of vulvovaginitis vs 1 (4.1%) specimen in the control group. Other specific organisms identified in the study group were Escherichia coli (12%), Haemophilus influenzae (5%), Staphylococcus aureus (4.3%), Candida albicans (4.3%), and Streptococcus agalactia (3.3%).

Conclusions: Among prepubescent girls with vulvovaginitis, 51.3% of vaginal cultures exhibited potential causative agents in the study group. Our microbiological data indicated that the most common pathogens were S. pyogenes and E. coli.

Keywords: Microbiological traits; Prepubescent children; Vulvovaginitis.

MeSH terms

  • Case-Control Studies
  • Child
  • Escherichia coli*
  • Female
  • Humans
  • Retrospective Studies
  • Streptococcus pyogenes
  • Vulvovaginitis* / diagnosis
  • Vulvovaginitis* / microbiology