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    Approach To Vaginal Discharge in Children

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    sujata
    This document discusses vaginal discharge in children and adolescents. It outlines that STIs/RTIs in children can be transmitted prenatally, during birth, or postnatally via breastfeeding, accidental contact, or sexual abuse. Common causes of vaginal discharge in adolescent females are endogenous vaginitis rather than STIs/RTIs. Gonorrhea and chlamydia infections are often asymptomatic but can cause symptoms like increased discharge or bleeding. Candida commonly causes vulvitis and discharge that worsens with menstruation. Bacterial vaginosis typically causes an adherent discharge without itching.

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    Approach To Vaginal Discharge in Children

    Uploaded by

    sujata
    37 views12 pages
    This document discusses vaginal discharge in children and adolescents. It outlines that STIs/RTIs in children can be transmitted prenatally, during birth, or postnatally via breastfeeding, accidental contact, or sexual abuse. Common causes of vaginal discharge in adolescent females are endogenous vaginitis rather than STIs/RTIs. Gonorrhea and chlamydia infections are often asymptomatic but can cause symptoms like increased discharge or bleeding. Candida commonly causes vulvitis and discharge that worsens with menstruation. Bacterial vaginosis typically causes an adherent discharge without itching.

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    Approach to Vaginal Discharge in Children

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    This document discusses vaginal discharge in children and adolescents. It outlines that STIs/RTIs in children can be transmitted prenatally, during birth, or postnatally via breastfeeding, accidental contact, or sexual abuse. Common causes of vaginal discharge in adolescent females are endogenous vaginitis rather than STIs/RTIs. Gonorrhea and chlamydia infections are often asymptomatic but can cause symptoms like increased discharge or bleeding. Candida commonly causes vulvitis and discharge that worsens with menstruation. Bacterial vaginosis typically causes an adherent discharge without itching.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    37 views12 pages

    Approach To Vaginal Discharge in Children

    Uploaded by

    sujata
    This document discusses vaginal discharge in children and adolescents. It outlines that STIs/RTIs in children can be transmitted prenatally, during birth, or postnatally via breastfeeding, accidental contact, or sexual abuse. Common causes of vaginal discharge in adolescent females are endogenous vaginitis rather than STIs/RTIs. Gonorrhea and chlamydia infections are often asymptomatic but can cause symptoms like increased discharge or bleeding. Candida commonly causes vulvitis and discharge that worsens with menstruation. Bacterial vaginosis typically causes an adherent discharge without itching.

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    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 12

    APPROACH TO VAGINAL

    DISCHARGE IN
    CHILDREN
    TRANSMISSION
    • STI/RTI in children can be acquired through three different ways:
    i transplacental (occurring in utero) or intrapartum transmission (during labour and
    delivery) e.g. syphilis, HIV, cytomegalovirus (CMV) and human papilloma virus
    infection (HPV)

    ii post-natal transmission (during breast feeding, accidental and through sexual


    abuse)

    iii due to sexual abuse or unsafe sexual practices among sexually active adolescents.

    • common sexual abuse encountered by girls is genital contact, masturbation,


    vaginal, oral or anal intercourse,
    • while boys are subjected to fellatio or anal intercourse.
    • In general, endogenous vaginitis rather than an STI/RTI is the main
    cause of vaginal discharge among adolescent females.

    • 85% of gonococcal infection in females will be asymptomatic.


    However, there may be vulval itching, minor discharge, urethritis or
    proctitis.

    • In prepubescent girls, a purulent vulvo vaginitis may occur.


    • Chlamydia trachomatis infection is asymptomatic in the majority of
    cases.

    • Symptoms that may occur in the adolescents are inter menstrual


    bleeding, post-coital bleeding and an increase in vaginal secretions.
    • Candida albicans is uncommon in adolescents prior to puberty. If
    present, the adolescent may have a discharge, vulval itching,
    dyspareunia, perianal soreness or a fissuring at the introitus.

    • Attacks of candida vulvitis may be cyclical in nature and correspond to


    menstruation.
    • Bacterial vaginosis does not produce vulvitis and the adolescent will
    not complain of itching or soreness
    Mostly Asymptomatic • Vulvitis

    • Gonococcal infection Plus


    • Chlamydia trachomatis • Whitish curdy discharge
    • vulval itching
    • dyspareunia
    • perianal soreness
    • fissuring at the introitus

    • Candida albicans
    (Attacks are cyclical in nature and
    corresponds with menstruation)
    • Vulvitis • Vulvitis

    Plus • purulent vulvo vaginitis


    • inter menstrual bleeding Plus
    • post-coital bleeding • vulval itching
    • an increase in vaginal secretions • minor discharge
    • urethritis
    Chlamydia trachomatis • Proctitis

    • gonococcal infection
    • Vulvitis • No vulvitis

    • greenish frothy discharge • adherent discharge


    • adolescent will not complain of
    • Trichomoniasis itching or soreness

    • Bacterial vaginosis
    Laboratory Investigations
    • Wet mount microscopy of the discharge for Trichomonas Vaginalis

    • 10% KOH preparation for Candida albicans

    • Gram stain of vaginal smear for clue cells seen in bacterial


    vaginosis
    Treatment
    Vaginitis (TV+BV+Candida)
    • Tab. Secnidazole 2 gm orally, single dose
    OR
    Tab. Tinidazole 500 mg orally, twice daily for 5 days
    OR
    Tab. Metronidazole 400 mg, twice daily for 7 days.

    • Treat for candidiasis with Tab Fluconazole 150 mg orally single dose
    Follow up

    After 7 days

    • To document symptomatic cure


    • If symptoms/signs persist assess whether it is due to lack of
    treatment compliance or treatment failure or re-infection and
    advise prompt referral

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