Tsai Hsiu-Yuan, Wan Chuan, Tseng Ching-Chang
Department of Pediatrics, Zhongxing Branch, Taipei City Hospital, Taipei, Taiwan.
Acta Paediatr Taiwan. 2006 Jan-Feb;47(1):43-6.
Vaginal discharge in young prepubertal girls is a common problem in clinical practice. No specific infective pathogen is identified in most of the children. The reported common microbes include group A beta-hemolytic streptococci, Haemophilus influenzae and some Gram-negative bacilli. Sexually transmitted pathogens such as Neisseria gonorrhoeae and Chlamydia trachomatis are important causes of vulvovaginitis in children suffering from sexual abuse. We report two cases of prepubertal vulvovaginitis presenting with profuse purulent vaginal discharge, and H. influenzae and N. gonorrhoeae identified respectively. Both girls denied any sexual exposure and there was no evidence of sexual abuse. They responded well to antibiotic treatment, and no symptoms recurred in the following months. We would like to emphasize the defined etiology of childhood vulvovaginitis and appropriate treatment, in addition to gynecological evaluation for evidence of sexual abuse.
青春期前女童的阴道分泌物异常是临床实践中的常见问题。大多数患儿未发现特定的感染病原体。报告的常见微生物包括A组β溶血性链球菌、流感嗜血杆菌和一些革兰氏阴性杆菌。性传播病原体如淋病奈瑟菌和沙眼衣原体是遭受性虐待儿童外阴阴道炎的重要病因。我们报告两例青春期前外阴阴道炎患儿,表现为大量脓性阴道分泌物,分别检出流感嗜血杆菌和淋病奈瑟菌。两名女童均否认有任何性接触史,且无性虐待证据。她们对抗生素治疗反应良好,在随后几个月中无症状复发。我们想强调的是,除了进行妇科评估以寻找性虐待证据外,还应明确儿童外阴阴道炎的病因并进行适当治疗。