Patient's question:
I got married last year. Recently, I've been experiencing lower abdominal pain, especially during my period. I'm very worried about it affecting my fertility, and I'm also extremely sensitive to cold and coldness. How should I diagnose and treat vulvovaginitis in young girls?Doctor's answer:
Infantile vulvovaginitis is a very common disease in female infants and young children. During diagnosis, it is necessary to differentiate it from trichomoniasis, candidiasis, pinworm vulvovaginitis, and acute gonococcal vulvovaginitis in young girls.1. Trichomoniasis or candidiasis vulvovaginitis: Due to the alkaline pH and lack of glycogen in the infant's vagina, it is not suitable for the reproduction and growth of fungi or trichomonads. Therefore, fungal or trichomoniasis vulvovaginitis in infants is extremely rare. In clinical differentiation, a smear and culture of secretions may be performed.
2. Pinworm vulvovaginitis: This is an inflammation of the vulva caused by pinworms transmitted from feces to the vulva and vagina. Its characteristics include intense itching in the vulva and anal area, excessive discharge with a thin, yellowish-purulent appearance. Differentiation can be made through fecal egg examination and the presence of pinworms around the anus or vulva.
3. Acute gonococcal vulvovaginitis in young girls: It is characterized by local pain and difficulty urinating. During examination, increased discharge, redness, swelling, and ulcers may be observed in the vestibule, urethral orifice, vulva, or perianal area. A smear of the discharge can reveal typical kidney-shaped Gram-negative diplococci.
[Comprehensive Therapy] The treatment of vulvovaginitis in young girls requires a comprehensive approach:
① Replace open-crotch pants with soft, clean cotton underwear. The mother should also maintain frequent hygiene for the girl's vulva and underwear.
② Gently insert a soft, thin sterile catheter into the girl's vagina and use an appropriately concentrated antiseptic solution to flush out inflammatory secretions through the catheter, once daily.
③ Bathe the girl in a warm potassium permanganate solution with a concentration of 1:5000 for 15 minutes, twice a day (morning and evening).
④ If urethritis and cystitis are complications, non-corrosive antiseptic medication can be directly injected into the urethra and bladder through the urethral orifice, every 5 days.
⑤ Take oral cephalosporin antibiotics.
⑥ If the girl has a sexually transmitted disease (e.g., gonorrhea, syphilis, or abnormal results in mycoplasma tests), she should undergo systematic treatment.
It should be noted that even after symptoms of vaginitis, urethritis, and cystitis disappear, and urine tests and vaginal discharge tests return to normal, oral antibiotics should still be continued for an additional week to consolidate the therapeutic effect.
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How to externally treat vulvovaginitis in female infants
Female infant vulvovaginitis is often caused by poor hygiene. Due to their young age, infants wearing open-crotch pants are prone to sitting on dirty surfaces or public toilet seats, leading to vulvar contamination and infection. The pathogens can vary, including bacteria, trichomonads, fungi, or pinworms. If redness, itching, increased discharge, or an odor is observed in the infant's vulva, medical examination is necessary to identify the cause and treat accordingly. In daily life, it is important to develop the habit of frequently cleaning the vulva and maintaining dryness and cleanliness. Underwear should be changed frequently. If possible, it is best for the child to have their own dedicated basin for cleaning.