4: Peds Vulvovaginitis Flashcards
1
Q
How does vulvovaginitis present in children?
A
- Dysuria
- Vulvovaginal pain and/or pruritis
- Local erythema
- Discharge
2
Q
What should be included in a hx for vulvovaginitis?
A
- Symptom analysis including dysuria, hematuria, abd pain, flank pain, fever, n/v.
- Ask specifics about any nocturnal enuresis. New or chronic?
- Ask specifics about discharge (how much, what color, odor).
- Ask about history of atopy/eczema.
- Ask if any concern over inappropriate physical contact.
3
Q
Should you perform an internal GU exam when suspicious for vulvovaginitis?
A
No.
- Perform oropharyngeal exam (strep or sexual abuse)
- Full abd exam (including CVA tenderness)
- External GU
- Q-tip for vaginal secretions for wet mount
4
Q
What diagnostic testing should be performed?
A
- UA, culture
- Possibly tape testing (pinworms)
- Wet mount/KOH
- If need to do STI screening be careful as it might have legal ramifications
5
Q
Treatment for nonspecific vulvovaginitis?
A
- Avoid all irritants (including soap) for approximately 2 days
- Wash well with warm water
- May use a low potency steroid and antifungal combo but not longer than 1 week