In order to emphasize the possibility of acquiring childhood candidal vulvovaginitis by sexual abuse, we report two cases of childhood candidal vulvovaginitis due to sexual abuse. The case 1 was a 6-year-old girl and the other case was a 7-year old girl. In these cases, the vulvas and vaginal walls were erythematous, edematous, pruritic and eroded. The diagnoses were confirmed by clinical picture and the 10% KOH preparation of vaginal discharge. The treatment of these patients were done by oral itraconazole for 1 week with successful results.
Child ; Cytochrome P-450 CYP1A1 ; Diagnosis ; Female ; Humans ; Itraconazole ; Sex Offenses* ; Vaginal Discharge ; Vulva ; Vulvovaginitis*

BACKGROUND: There are limited data regarding the antifungal susceptibility of Candida albicans causing recurrent vulvovaginal candidiasis. OBJECTIVE: The aim of the present study was to evaluate the effect of azoles susceptibilities on treatment failure and recurrence of vulvovaginal candidiasis. METHODS: Species identification was performed on 84 vaginal Candida isolates collected from October 2008 to June 2010 from 404 patients with suspected vulvovaginitis. MICs of C. albicans (26 isolates) to fluconazole, itraconazole, and voriconazole were tested by broth microdilution method of the Clinical and Laboratory Standards Institute (CLSI) M27-A2. RESULTS: C. albicans was the most frequently isolated (88.1%). All isolates were susceptible to fluconazole, itraconazole, and voriconazole. Trailing growth was found in treatment success group (10.0%) and treatment failure group (33.3%). CONCLUSIONS: The results of this study suggest the possibility that trailing growth have influence on treatment failure of vulvovaginal candidiasis.
Azoles ; Candida ; Candida albicans ; Candidiasis, Vulvovaginal ; Danazol ; Fluconazole ; Humans ; Itraconazole ; Pyrimidines ; Recurrence ; Treatment Failure ; Triazoles ; Vulvovaginitis

Five cases of childhood candidal vulvovaginitis, each having clinical features of vulva erythema, pnuritus, and vaginal discharge, were examined. Circumst. antially, t.he suspected sources of infection and the attributatble factors for the candiclal nfection in these patients were mother of the children who had known candidal vulvovaginitis, and chronic diarrhea of the children. Regarding the treatment of these patients, 3 were given oral ketocanazole and 2 were treated with intravaginal clotrimazole preparations for more than 1 week with successful result. Concern for better hygiene in the anogenital area seems to be important in the prevention of childhood candidal vulvovaginitis.
Child ; Clotrimazole ; Diarrhea ; Erythema ; Humans ; Hygiene ; Mothers ; Vaginal Discharge ; Vulva ; Vulvovaginitis*

OBJECTIVE: To update information on the clinical and microbiologic characteristics of pediatric vulvovaginitis in Korean prepubertal girls. METHODS: A total of 120 girls (aged 0 to 9 years) with culture-confirmed pediatric vulvovaginitis, diagnosed between 2009 and 2014, were enrolled in the study. The epidemiologic and microbiologic characteristics, and clinical outcomes were assessed. Patients with sexual precocity, as well as those who were referred for suspected sexual abuse, were excluded. RESULTS: Girls aged 4 to 6 years were at the highest risk of pediatric vulvovaginitis. Seasonal distribution indicated obvious peaks in summer and winter. Of the 120 subjects, specific pathogens were identified in the genital specimens in only 20 cases (16.7%). Streptococcus pyogenes (n=12, 60%) was the leading cause of specific vulvovaginitis. Haemophilus influenzae was isolated in one patient. No cases presented with enteric pathogens, such as Shigella or Yersinia. A history of recent upper respiratory tract infection, swimming, and bubble bath use was reported in 37.5%, 15.8%, and 10.0% of patients, respectively. Recent upper respiratory tract infection was not significantly correlated with the detection of respiratory pathogens in genital specimens (P>0.05). Of 104 patients who underwent perineal hygienic care, 80 (76.9%) showed improvement of symptoms without antibiotic treatment. Furthermore, the efficacy of hygienic care was not significantly different between patients with or without specific pathogens (P>0.05). CONCLUSION: Specific pathogens were only found in 16.7% of pediatric vulvovaginitis cases. Our results indicate an excellent outcome with hygienic care, irrespective of the presence of specific pathogens.
Baths ; Female* ; Haemophilus influenzae ; Humans ; Respiratory Tract Infections ; Seasons ; Sex Offenses ; Shigella ; Streptococcus pyogenes ; Swimming ; Vulvitis ; Vulvovaginitis* ; Yersinia

OBJECTIVES: The purpose of this study was to assess the clinical features, microbiologic results, and the efficacy of perineal hygienic care of pediatric vulvovaginitis. METHODS: Forty-two unselected premenarcheal patients with symptoms or signs of vulvovaginitis who were attended the outpatient pediatric and adolescent gynecology clinic at Pundang CHA General Hospital from August 1997, to September 1999 were systematically interviewed and examined using a standardized format, studied microbiologically, and followed the efficacy of perineal hygienic measures prospectively. RESULTS: The median age of the patients was 4.8 years (range 2.9 years to 10.9 years). Vaginal complaints of 42 patients were discharge(79%), genital pain or irritation(31%), odor(17%), pruritus(14%), and vaginal bleeding(7%). On physical examination, vaginal discharge and vulvar erythema were noted in 17(40%) and 22(52%) patients, respectively. Aerobic bacteria or yeast excluding vaginal normal flora were found in 24 of 42 patients(57%). Convincing evidence of specific pathogens was found in 9 of 42 patients(21%) including one case of pinworm infestation. Isolated pathogens were H. influenza(3), S. pyogenes(2), K. pneumonia(2) and N. gonorrhea(1). No patients were found to have chlamydial infection or trichomoniasis. In 14 patients, risk factors were identified such as swimming(14%), bubble bath(5%), sexual abuse(5%), genital trauma(5%) and foreign body(2%). After two weeks instructions of perineal hygienic care, 26(62%) of 42 patients revealed complete resolution of symptoms and signs of vaginitis without antibiotics. Efficacies of perineal hygienic care were 94%(17/18) in the patients with normal flora alone, 60%(9/15) in the patients with organisms suspected for nonspecific infection and 0%(0/9) in the patients with specific pathogens(p<0.05). CONCLUSION: Majority(62%) of the pediatric patients with symptoms or signs of vulvovaginitis were cured with perineal hygienic care alone. And the efficacy of hygienic measure were higher in the patients without specific pathogens(79%, 26/33). Therefore, proper physical examination, microbiologic study and appropriate instructions of perineal hygienic care were more important than empirical antibiotic treatment in initial management of pediatric vulvovaginitis.
Adolescent ; Anti-Bacterial Agents ; Bacteria, Aerobic ; Enterobius ; Erythema ; Gynecology ; Hospitals, General ; Humans ; Outpatients ; Physical Examination ; Prospective Studies ; Risk Factors ; Vaginal Discharge ; Vaginitis ; Vulvovaginitis* ; Yeasts

Candidiasis is an acute or chronic infection caused most commonly by Candida albicans and occasionally by other species of the genus Candida. The superficial cutaneous candidiasis is varied; oral Candidiasis, perieche, candidal vulvovaginitis, candidal balanitis, candidal intertrigo, erosio interdigitalis blastomycetica, perianal candidiasis, candidal paronychia, candidal onychia, chronic mucocutaneous candidiasis, congenital cutaneous candidiasis, and candidid. Diagnosis can be made by typical appearance of the clinical lesions and the presence of satellite vesicopustules. This can be confirmed by KOH examination and culture of skin scrapings. Treatment is the correction of predisposing factors, topical therapy of imidazoles and/or systemic administration of itraconazole or fluconazole.
Balanitis ; Candida ; Candida albicans ; Candidiasis ; Candidiasis, Chronic Mucocutaneous ; Candidiasis, Cutaneous* ; Candidiasis, Oral ; Causality ; Diagnosis ; Fluconazole ; Imidazoles ; Intertrigo ; Itraconazole ; Male ; Paronychia ; Skin ; Vulvovaginitis

Candida vulvovaginitis is caused by Candida albicans or, occasionally, by other Candida species, Toruopsis species (also known as Candida glabrata), or other yeasts. An estimated 75% of women have at least one episode of Candida vulvovaginitis, and 40~45% have two or more episodes. Asmall percentage of women (less than 5%) experience recurrence. Typical symptoms of Candida vulvovaginitis include pruritus and vaginal discharge. Other symptoms may include vaginal soreness, vulvar burning, dyspareunia, and external dysuria. Candida vulvovaginitis is often associated with the use of broad-spectrum antibiotics, pregnancy, low vaginal pH, and diabetes mellitus. Sexual activity and oral contraception may also be contributing factors. In healthy individuals, Candida species usually remain superficial and respond readily to treatment. The infection by these species depends upon the immune status, as well as the normal vaginal flora status, of the potential host.
Anti-Bacterial Agents ; Burns ; Candida ; Candida albicans ; Contraception ; Diabetes Mellitus ; Dyspareunia ; Dysuria ; Epidemiology ; Female ; Humans ; Hydrogen-Ion Concentration ; Pregnancy ; Pruritus ; Recurrence ; Sexual Behavior ; Vaginal Discharge ; Vulvovaginitis* ; Yeasts

OBJECTIVETo study the clinical effect and mechanism of Jietongyin Lotion (JTYL) in treating vulvovaginitis in young girls.

METHODSPatients were randomized into the JTYL group (n = 300) and the control group (n = 60, treated with Rishu an Lotion). Comparative observation on scoring of main symptoms and signs in them was carried out, and the pharmacological and pharmacodynamic experiment was also conducted on effect of JTYL in animals.

RESULTSIn the JTYL group, the total effective rate was 98% and was 93% in the control group. The cure rate in the two groups was 93% and 83% respectively, which was significantly higher in the JTYL group (P < 0.05). Experimental study showed that JTYL has effects in anti-inflammation, bacteriocidal, itching relieving, pain releasing, and immune regulation. It showed non-irritatory on mucous membrane.

CONCLUSIONJTYL has good reliable effect in treating vulvovaginitis in young girls without any obvious adverse effects, showing anti-inflammatory, bacteriocidal, itching relieving, pain releasing and immune regulation.

Administration, Topical ; Animals ; Anti-Infective Agents ; administration & dosage ; pharmacology ; Baths ; Child ; Child, Preschool ; Drugs, Chinese Herbal ; administration & dosage ; pharmacology ; Female ; Guinea Pigs ; Humans ; Infant ; Male ; Mice ; Phytotherapy ; Rabbits ; Random Allocation ; Vulvovaginitis ; drug therapy

OBJECTIVETo study the relationship between vulvovaginitis in pre-pubertal girls and pathogens as Chlamydia trachomatis (Ct), N. gonorrhoeae (Ng), Mycoplasma, Ureaplasma urealyticum (Uu), Mycoplasma hominis (Mh), M. genitalium (Mg), M. fermentans (Mf) and M. penetrans (Mpe), as well as to find out the proportion of mycoplasma which is correlated to sexually transmitted diseases (STD) and AIDS. METHODS Vulvae swab specimens from 285 pre-pubertal girls with vulvovaginitis (case group) and 128 healthy girls (control group) were collected and detected by nested polymerase chain reaction (nPCR) to identify the existence of pathogens as Ct, Ng, Uu, Mh, Mg, Mf and Mpe. nPCR with both high specificity and sensitivity, would not be influenced by the amount of pathogens in specimens or inactivated during the process of storage or transportation.

RESULTSThe rate of detection on pathogens was 59.65% in the 285 specimens from case group including 'one kind of pathogen in one specimen' as 37.54% and 'two kinds' as 16.84% and 'three kinds' as 5.26%. However, in the 128 specimens from control group, the detectable rate of pathogen was 6.25%. Relationships were found between Ng (P < 0.01), Ct (P < 0.01), Uu (P < 0.01), Mg (P < 0.01), Mf (P < 0.05), Mpe (P < 0.01) and vulvovaginitis in pre-pubertal girls. In control group the pathogens were detected from 7 specimens including 5 Uu and 2 Mh.

CONCLUSIONSome of the pathogens were correlated to STD and were important in causing vulvovaginitis in pre-pubertal girls. Vulvovaginitis might have been caused by more than one kind of pathogen in pre-pubertal girls. The locations of Mg, Mf and Ng in outer genital tracts were correlated to seasonal change. Macrolide seemed to be quite effective clinically in treating urogenital tract infection caused by mycoplasma and Ct.

Case-Control Studies ; Child ; Child, Preschool ; China ; Chlamydia Infections ; complications ; Chlamydia trachomatis ; isolation & purification ; Female ; Gonorrhea ; complications ; Humans ; Mycoplasma ; isolation & purification ; Mycoplasma Infections ; complications ; Neisseria gonorrhoeae ; isolation & purification ; Seasons ; Sensitivity and Specificity ; Sexually Transmitted Diseases ; complications ; microbiology ; Ureaplasma Infections ; complications ; Ureaplasma urealyticum ; isolation & purification ; Vulvovaginitis ; etiology ; microbiology