Vulvar symptoms in paediatric and adolescent patients

Vulvovaginal symptoms in children and young adolescents are not yet very we ll understood. nor is the actual incidence known. This study evaluates the character and possible infectious aetiology of vulvar symptoms of females a ged up to 16 y. The signs, symptoms and bacteriological findings of 68 cons ecutive cases were studied. The study was conducted in the University Hospi tal of Tampere at a special gynaecological consultation clinic for children and adolescents. Sixty-eight patients were included in the study: 48 girls (71%) were prepubertal, at Tanner stage M1P1, 26 patients were 2-4-y-old a nd 15 were 5-7-y-old. The duration of symptoms was known for 46 patients: 4 1% had had symptoms for >1 mo and 20% for >6 mo. Forty-eight patients had a bnormal clinical findings on examination and 16 (33%) of them had an infect ious aetiology. Streptococcus pyogenes infection was identified in 11 (16%) patients, all of whom had symptoms. Candida was identified in 6 (9%) patie nts. No infectious aetiology was found among 26 patients who had symptoms a nd abnormal clinical findings. Vulvovaginal symptoms during childhood are m on common among younger children (<7 y). In 67% of patients no infectious a etiology could be found. Samples for microbiological culture should be take n from symptomatic patients and symptomatic areas. Cultures of Candida and bacteria are necessary but usually sufficient. If a microbiological aetiolo gy is established, treatment can be assigned accordingly. Patients with vulvar symptoms and findings but with an unclear aetiology ne ed support and advice on proper hygiene and can intermittently Use mild cor ticosteroids locally.