Clinical Recommendation: Vulvovaginitis

Clinical and Microbiological Findings of Vulvovaginitis in Prepubertal Girls

“…4,8e12 Similarly, it was difficult to relate the clinical features of vulvovaginitis to specific pathogens that might be causing this illness, but the manifestation of the disease was more acute when individual or dominant bacteria were found. 7,8 Vulvovaginitis in prepubertal girls has been reported as nonspecific in 25%-75% of cases, 2,6,9,12 as was also the case in the present study, in 59.6% of symptomatic girls. Consequently, the vaginal swab culture results should be evaluated with great caution because the bacteria detected could simply represent normal vaginal microflora (Table 3).…”

“…The data from other studies revealed that Staphylococcus aureus was excluded in 2.5%-7% of the patients. 5,7,14 Staphylococcus aureus was detected in 3 (3.2%) girls in our study, only 1 (1.06%) of whom had symptoms of vulvovaginitis. Mostly, Staphylococcus aureus was revealed in mixed culture and was not considered the main pathogen.…”

“…The prevalence of these types of bacteria is caused by their dissemination in the whole body and high viability. 7 Our study had several limitations. We had difficulties in recruiting the control group because of social and cultural perceptions, as well as persuading parents/guardians to provide consent for interventions in healthy girls.…”

“…In prepubertal girls, Lactobacilli, Diphteroids, and Gardnerella Vaginalis are usually absent, which permits pathogenic and opportunistic bacteria to alter the vaginal epithelium, causing vulvovaginitis. 4,6,7 Thus the presence of opportunistic bacteria in vaginal swab culture during vulvovaginitis is of clinical relevance. In this study, opportunistic pathogens as a pure culture were detected in 7 symptomatic girls, and specific pathogens were identified in 9 (Table 4).…”

Vulvovaginitis in pre-pubertal and adolescent girls (a review)

“…Малые половые губы недостаточно развиты, в то время как в области больших половых губ минимально выражена подкожная жировая клетчатка и полностью отсутствуют лобковые волосы. Перечисленные особенности, а также близкое анатомическое расположение наружных половых органов к заднему проходу приводят к повышению подверженности влагалища контаминации возбудителями заболеваний из анального отверстия [8].…”