O'Connor P A, Oliver W J
Pediatr Emerg Care. 1985 Jun;1(2):94-5.
Differential diagnosis of purulent vulvovaginitis in prepubertal girls should include infection caused by group A beta-hemolytic streptococci. Cultures should be obtained not only for N. gonorrhoeae but also for respiratory and skin pathogens such as streptococci. While a specific diagnosis of group A streptococcal vulvovaginitis does not exclude child abuse or a vaginal foreign body, the child's symptoms and parental anxiety and concern can usually be rapidly alleviated with oral antibiotics effective against streptococci. Further investigation beyond culturing and treatment with antibiotics can be reserved for cases where history, physical findings, and response to therapy indicate such a need.
青春期前女孩脓性外阴阴道炎的鉴别诊断应包括由A组β溶血性链球菌引起的感染。不仅应进行淋病奈瑟菌培养，还应进行呼吸道和皮肤病原体（如链球菌）的培养。虽然A组链球菌性外阴阴道炎的明确诊断不排除虐待儿童或阴道异物，但使用对链球菌有效的口服抗生素通常可迅速缓解患儿的症状以及家长的焦虑和担忧。对于病史、体格检查结果及治疗反应表明有此必要的病例，可在培养和抗生素治疗之外进行进一步检查。
