1/2. 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 = 1keywords = physical (Clic here for more details about this article) |
2/2. Psychosomatic vulvovaginitis.Psychosomatic vulvovaginitis is a real clinical entity that should be suspected in any patient whose vaginal complaints do not correlate with the physical findings. Such patients have usually seen multiple physicians, are "allergic" to most vaginal medications, and exhibit signs of emotional lability. In many cases, psychiatric evaluation and therapy can be of great benefit.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |