1/3. Childhood vulvovaginitis: report of two cases.vaginal discharge in young prepubertal girls is a common problem in clinical practice. No specific infective pathogen is identified in most of the children. The reported common microbes include group A beta-hemolytic streptococci, haemophilus influenzae and some Gram-negative bacilli. Sexually transmitted pathogens such as neisseria gonorrhoeae and chlamydia trachomatis are important causes of vulvovaginitis in children suffering from sexual abuse. We report two cases of prepubertal vulvovaginitis presenting with profuse purulent vaginal discharge, and H. influenzae and N. gonorrhoeae identified respectively. Both girls denied any sexual exposure and there was no evidence of sexual abuse. They responded well to antibiotic treatment, and no symptoms recurred in the following months. We would like to emphasize the defined etiology of childhood vulvovaginitis and appropriate treatment, in addition to gynecological evaluation for evidence of sexual abuse.- - - - - - - - - - ranking = 1keywords = gonorrhoeae (Clic here for more details about this article) |
2/3. Group A beta-hemolytic streptococcal vulvovaginitis: a recurring problem.Differential diagnosis of purulent vulvovaginitis in prepubertal girls should include infection caused by group A beta-hemolytic streptococci. Cultures should be obtained not only for N. gonorrhoeae but also for respiratory and skin pathogens such as streptococci. While a specific diagnosis of group A streptococcal vulvovaginitis does not exclude child abuse or a vaginal foreign body, the child's symptoms and parental anxiety and concern can usually be rapidly alleviated with oral antibiotics effective against streptococci. Further investigation beyond culturing and treatment with antibiotics can be reserved for cases where history, physical findings, and response to therapy indicate such a need.- - - - - - - - - - ranking = 0.5keywords = gonorrhoeae (Clic here for more details about this article) |
3/3. Prepubertal infections with neisseria gonorrhoeae: clinical and epidemiologic significance.The family constellations and epidemiologic circumstances of three prepubertal girls with vulvovaginitis due to neisseria gonorrhoeae are reported. In each instance, an infected asymptomatic man, himself a contact to a woman with pelvic inflammatory disease, could be implicated as the potential source of infection. In one instance, asymptomatic infection in a child was uncovered through epidemiologic investigation. Prepubertal gonococcal vaginitis is important not only as a potential indicator of child abuse, but also as a possible link to important transmitters of gonococcal infection. The need for meticulous epidemiologic investigation of these cases is stressed.- - - - - - - - - - ranking = 2.5keywords = gonorrhoeae (Clic here for more details about this article) |