There are always some parents who ask what is wrong with their little princesses who have recurrent redness, itching and even breakouts on their vulva. What should I do? We tell the parents that their child may have vulvovaginitis, and the mothers are surprised. Can babies get it too? Because of physiological factors and anatomical features such as low estrogen levels in early childhood, underdeveloped vulva, labia majora not covering the vaginal opening, and improper care by parents and friends, young girls are more likely to develop the disease. According to statistics the disease accounts for 50-60% of pediatric gynecology outpatient visits, but in most general hospitals there is no pediatric gynecology department, so parents tend to come to pediatrics for consultation. Let’s learn about it briefly.
Vaginitis in young girls mostly occurs in young girls less than 8 years old. Because vaginitis is mostly accompanied by vulvovaginitis, it is often collectively called vulvovaginitis in young girls.
Causes
1. Poor local hygiene is often due to unclean vulva, not washing vulva daily; incorrect method of wiping stool, the habit of wiping stool from back to front; often wear crotch pants to sit and lie anywhere, vulva is contaminated or direct contact with pollutants.
2.Contagious directly by the mother who has vulvovaginitis or through contaminated clothes, bath tubs, towels and other utensils; the seats of bathhouses and swimming pools are also one of the tools of transmission.
3. Pinworms cause vulvovaginitis, but pinworm infections are now uncommon because sanitary conditions have improved significantly. Intestinal pinworms are transmitted through feces to the vagina and cause inflammation. Inflammation is caused by the contamination of pinworm eggs in the vulva of young girls through people or objects, etc. by improper fecal disposal.
4, Secondary to upper respiratory tract infection, intestinal infection, urinary tract infection, children’s fingers can bring nasopharyngeal secretions to the vulva; contaminated feces and infected urine can flow to the vulva and cause infection when improperly cared for.
5. Obesity, frequent wearing of tight pants, long time with diaper wetting.
[Clinical manifestations
The amount of discharge varies. In the acute stage, the vulva and vaginal mucosa will be congested and even oozing with blood, and there will be a small amount of bloody discharge.
More purulent discharge impregnation causes vulvar skin rupture and in serious cases leads to superficial ulcers. Some of them do not attract parents’ attention in the acute stage and may lead to adhesion of labia minora.
[Examination].
The vulva is red and swollen, the vestibular mucosa and vaginal opening mucosa are flushed and congested, yellow purulent discharge can be seen from the vaginal opening, if no discharge is seen, anal examination can be done.
Diagnosis
Ask the mother of the child and the nursery staff for a detailed medical history. The diagnosis can be confirmed by combining the typical clinical manifestations: redness, swelling, itching, pain and purulent discharge from the vulva. Perform pathogenetic diagnosis if necessary.
【Treatment】
External drug bath: potassium permanganate solution, concentration 1:5000-1:10000, 2 times a day, 10 minutes each time, 7 days a course of treatment.
External Chinese medicine: 20g of bitter ginseng, 15g of raw lily of the valley, 10g of cypress, 20g of white fresh peel, 20g of summer cucumber, 15g of hyoscyamus. method: put in gauze bag, decoct 1000-2000ml of water, first smoked vulva, sit in bath for 15-20 minutes when the temperature is suitable, twice a day.
Increase the resistance of vagina and inhibit the growth of bacteria: 50ml of 0.5%-1% lactic acid solution is used to irrigate the vagina through a small rubber catheter to increase the acidity of the vagina and improve the resistance of the vagina to infection, once a day for 7 days as a course of treatment. An ointment containing 0.1 mg of hexestrol can also be applied deep into the vagina with a small cotton swab once a day for 7 days.
Treatment with antimicrobials: choose appropriate antibiotics for oral administration such as amoxicillin, cephalosporins, etc.; also apply local antibiotic eye drops such as chloramphenicol eye drops, ofloxacin eye drops, etc.; apply erythromycin ointment for external application if extensive skin mucous membrane is damaged.
Pinworm vaginitis: apply pinworm cream externally every night and rinse the vulva with water in the early morning; take oral paracetamol 5mg/kg at night, and if there is recurrence, take it every 2-3 weeks.
Prevention
Towels, clothing and washing utensils should be used exclusively to avoid cross-infection.
Emphasize hygiene education for girls, cultivate good hygiene habits, wash hands before and after defecation, wipe from front to back after defecation, and do not sit and lie anywhere.
Keep the vulva clean and dry, wash the vulva every day, change diapers regularly for infants, and do not wear open crotch pants for young children. Do not wear tight pants.
Enhance physical fitness and prevent infections of the respiratory, intestinal and urinary tracts.