Do we need to treat vulvovaginitis in prepubertal girls?
Joishy, M.; Ashtekar, C.S.; Jain, A.; Gonsalves, R.
BMJ 330(7484): 186-188
2005
ISSN/ISBN: 1756-1833 PMID: 15661783 DOI: 10.1136/bmj.330.7484.186Document Number: 240455
This review presents available evidence on the management of vulvovaginitis in prepubertal girls. The aetiology, pathogenesis and clinical features of vulvovaginitis are discussed. The conclusions are summarized as follows: (i) vulvovaginitis is the commonest gynaecological problem in prepubertal girls; (ii) the hypo-oestrogenic hormonal milieu in such girls increases the susceptibility of the vaginal mucosa to infection; (iii) vaginal microflora have not been well studied in normal prepubertal girls, making it difficult to decide whether bacteria isolated from a patient's vaginal secretions are part of the normal microflora or are the cause of symptoms of vulvovaginitis; (iv) current evidence suggests that in prepubertal girls with clinical features of vulvovaginitis, antibiotics should be used only if a pure or predominant growth of a pathogen is identified; and (v) isolating an organism associated with sexual transmission should prompt a careful evaluation for sexual abuse.