Infant vulvovaginitis
Introduction
Introduction to infantile vulvovaginitis Infants and young children ovarian function is not perfect, lack of estrogen; poor vulva development, vaginal mucosa, low vaginal epithelial resistance; vagina close to the anus is very susceptible to bacterial infection and prone to vulvovaginitis. basic knowledge Sickness ratio: 0.1% Susceptible people: children Mode of infection: non-infectious Complications: vulvar ulcer
Cause
The cause of vulvovaginitis in infants and young children
(1) Causes of the disease
1. Anatomy of infants and young children The development of young girls' vulva is poor, and bacteria are easy to invade.
2. Infants and young children's vaginal environment and adult different births after a few hours, the vaginal can detect bacteria, due to the mother and placental estrogen, the vaginal epithelium is rich in glycogen, vaginal pH is low, 4 ~ 4.5, at this time, the dominant flora in the vagina is Lactobacillus, 2 to 3 weeks after birth, the level of estrogen decreased, the pH value rose to 6-8, susceptible to other bacterial infections.
3. Infant health habits Poor vulva, clean stool, vulvar injury or mites infection can cause inflammation.
4. Vagina misplaced foreign bodies Infants are curious, placing rubber, buttons, cores, hairpins and other foreign objects in the vagina, causing secondary infections.
(two) pathogenesis
Infants and young children have poor vulva development, can not cover the urethra and vaginal vestibule, pathogens are easy to invade, common pathogens are Escherichia coli and staphylococcus, streptococcus, in addition, Neisseria gonorrhoeae, trichomoniasis, Candida is also a common pathogen Escherichia coli is the most common, accounting for about 80%. The vaginal secretions are acidic within 2 weeks after birth, and the pH value is about 5.5. After that, the estrogen entered by the mother is exhausted and the estrogen level is decreased. The vaginal epithelium is gradually thinner, the glycogen is reduced, the secretion is mostly alkaline or neutral, the pH value in the vagina rises, the lactobacillus is no longer a dominant vaginal bacterium, resulting in decreased resistance, and the infant's own anti-infective ability is poor. Poor hygiene habits when nursing, the vulva is unclean, directly contaminated with stool, mites cause genital itching, scratching the epidermis, mucous membranes and vaginal foreign bodies, causing bacteria to invade and inflammation.
Prevention
Infantile vulvovaginitis prevention
Pay attention to the vulva of infants and young children, vaginal hygiene, correct bad hygiene habits, standardize treatment, and prevent complications.
Complication
Complications of vulvovaginitis in infants and young children Complications vulvar ulcer
Severe cases can be complicated by vulvar ulcers, labia minora adhesions, vaginal atresia.
Symptom
Infantile vulvovaginitis symptoms Common symptoms Vulvar vulcanization when urinating... Vulvar burning irritating vulvar swelling Infants and young children vulvar pain urinary frequency dysuria Urinary vaginal discharge increased
Some children are often crying because of pain or itching of the vulva. It is caused by a large amount of secretions that cause genital itching, causing the child to cry, irritability or scratching the vulva with the hand. The main symptom is increased vaginal discharge and purulent. Clinically, the mother found that there were purulent secretions on the underwear of infants and young children. Some children were accompanied by urinary tract infections, urgency, frequent urination, dysuria, some labia minora adhesions, and fine urine flow during urination. Or divided, check visible vulva, clitoris, urethra, vaginal mucosa congestion, edema, small labia adhesions thin, translucent, purulent secretions from the vaginal opening, severe lesions, vulvar surface can be seen ulcers, small Adhesions can occur in the labia, and the labia minora sometimes covers the vaginal opening and the urethral opening. There may be a fissure on the upper and lower sides of the adhesion. The urine is discharged from the fissure, and sometimes it is clinically misdiagnosed as a genital malformation.
The disease is only seen in infants and young children, genital itching often makes children crying and restless, with the hand to grasp the vulva, the vagina has purulent secretions, check the vulva, clitoris, urethra and vaginal mucosa congestion, edema, secretion examination Pathogens can be found.
Examine
Examination of vulvovaginitis in infants and young children
Use a cotton swab or pipette to take vaginal secretions to find trichomoniasis, Candida, vaginal secretions smear Gram stain or bacterial culture, drug susceptibility test, find pathogenic bacteria (including gonorrhea), mycoplasma, chlamydia Etc. to identify pathogens for easy diagnosis; susceptibility testing is convenient for treatment.
Do an anal examination to exclude vaginal foreign bodies and tumors or to perform vaginal examination under anesthesia to exclude vaginal foreign bodies and tumors.
Diagnosis
Diagnosis and diagnosis of vulvovaginitis in infants and young children
Combined with medical history, clinical manifestations, and physical examination, a preliminary diagnosis can usually be made. Infants and young children have poor verbal ability. It is often necessary to ask the girl mother in detail when collecting medical history. At the same time, ask the mother whether there is a history of vaginitis or not, and whether there is a history of hand, foot and sputum. Infants and young children have a history of bathing in public places and care of bad hygiene habits, and the vulva is unclean and so on.
Vaginal foreign body and genital tract tumors.
