Pierce A M, Hart C A
Accident and Emergency Department, Royal Liverpool Children's Hospital, Alder Hey.
Arch Dis Child. 1992 Apr;67(4):509-12. doi: 10.1136/adc.67.4.509.
Over a period of 33 months in a paediatric accident and emergency department, the clinical pattern and possible causes of vulvovaginitis were studied prospectively in 200 girls presenting with genital discharge, irritation, pain, or redness. The major causes were poor hygiene and threadworms. The suspicion of sexual abuse arose in a few girls but no organisms of sexually transmitted disease were found. Urinary symptoms were common but only 20 patients had a significant bacteriuria and 40 had sterile pyuria. Specific skin problems occurred in 28 cases. Simple measures to improve hygiene and treatment of threadworms gave effective relief. Genital irritation caused urinary symptoms with no clinical evidence of infection, and it is advised that antibiotic treatment should await urine culture. Specific skin problems require help from a dermatologist. The possibility of sexual abuse must be considered especially if the vulvovaginitis is persistent or recurrent after adequate treatment.
在一家儿科急诊部门的33个月期间，对200名出现生殖器分泌物、瘙痒、疼痛或发红症状的女童的外阴炎和阴道炎的临床模式及可能病因进行了前瞻性研究。主要病因是卫生状况差和蛲虫感染。少数女童被怀疑遭受性虐待，但未发现性传播疾病病原体。泌尿系统症状很常见，但只有20例患者有显著菌尿，40例有无菌性脓尿。28例出现特定的皮肤问题。改善卫生状况和治疗蛲虫的简单措施能有效缓解症状。生殖器刺激会导致泌尿系统症状，但无感染的临床证据，建议在进行尿培养后再使用抗生素治疗。特定的皮肤问题需要皮肤科医生的帮助。尤其是在经过充分治疗后外阴炎和阴道炎仍持续或复发时，必须考虑性虐待的可能性。
