Infantile vaginitis

　　Vaginitis in infants and young children is caused by various causes. The main causes are as follows:

　　1. Poor vulvar hygiene The mother and caregivers of the child do not pay attention to the cleanliness of the child's vulva, handle feces improperly after defecation, or wipe the anus with contaminated paper, causing intestinal bacteria to enter the vagina and causing vaginitis. In the study of 438 cases of vulvovaginitis in infants and young children by HuHiman, it was found that 68% were caused by the above causes, among which 80% were found to be Escherichia coli during culture.

　　2. Foreign objects If peanuts, beans, hairpins, safety pins, small stones, etc., are inserted into the vagina, secondary infection occurs due to damage to the vaginal epithelium caused by foreign bodies.

　　3. Enterobius vermicularis vulvovaginitis Under normal circumstances, this disease is not common. It is caused by enterobius vermicularis entering the vagina through feces; or improper handling of feces, through the hands or clothes of the mother or caregivers, or toys, etc., to contaminate the vulva of the young girl with ovum of enterobius vermicularis, causing inflammation.

　　4. Secondary vulvar and vaginal inflammation After upper respiratory tract infection or urinary tract infection in young girls, bacteria can directly enter the vagina through dust, causing infection.

　　5. Specific vaginitis Trichomoniasis or fungal vaginitis is rare in infants and young children. The reason may be that the vaginal pH of infants and young children is alkaline, which is not suitable for the proliferation of fungi. Trichomonads feed on glycogen, and there is little glycogen in the vagina at this age, so it is also not suitable for the growth of trichomonads. Hemolytic vaginitis is extremely rare in infants and young children.

　　Infantile vulvovaginitis can cause congestion and edema of the vulva, urethral orifice, and vaginal orifice mucosa, with purulent secretions. Some children may have complications such as nausea, vomiting, abdominal pain, and diarrhea after taking medication. If not treated effectively, it may cause ascending infection of bacteria in the vagina, leading to cervical inflammation or cervical erosion and other gynecological diseases. Some inflammations may also affect other organs, causing pelvic inflammatory disease, adnexitis, and other reproductive organ inflammations. Severe cases can lead to infertility in women, which is because the inflammatory cells in the vagina can affect the movement of sperm or engulf sperm, causing infertility.

　　The main symptoms of infantile vulvovaginitis are itching of the vulva and an increase in vaginal secretions. Infants and young children cannot describe their symptoms correctly and often scratch the vulva with their fingers, which further spreads the infection. The vulva, urethral orifice, and vaginal orifice mucosa become congested and edematous with purulent secretions. There may also be neglect by parents during the acute phase, or because the symptoms are mild, causing adhesion of the labia minora after the acute phase. When adhesions occur, there may be small holes above or below, and urine flows out through the small holes. Vaginal foreign bodies can cause a large amount of vaginal secretions, which are bloody, purulent, and have an odor. Vaginitis caused by pinworms can cause severe itching around the vulva and anus, and a large amount of thin, yellow, purulent secretions are discharged from the vagina.

　　To prevent infantile vulvovaginitis, attention should be paid to the hygiene of the perineum of infants and young children in daily life to prevent infection. In view of the etiology, as parents, one should pay more attention to and love the child, educate and guide the child to love hygiene, keep the vulva clean, wear loose pants, reduce friction, wash clothes separately for adults and children, reduce joint bathing, and other common bath methods, prevention is better than treatment. Maintaining the hygiene of the genital area should be the most critical.

　　Due to the anatomical characteristics of infants and young children, diagnosis is somewhat difficult, but physical examination is the main basis for diagnosis. Therefore, doctors need to be highly patient and meticulous in asking the mother and caregivers of the children in detail about the medical history. The technique should be light and agile. Sometimes, in order to obtain satisfactory examination results, it is necessary to distract the child's attention, such as talking to the child while examining, so that the abdominal wall relaxes. In some cases, it is necessary to examine the child under general anesthesia. Common examination methods include:

　　1. Examination of the Vulva

　　Gently separate the labia majora with the middle and index fingers, and carefully observe the vulva, urethra, and prepuce, etc.

　　2. Vaginal Scope Examination

　　The best examination instrument is the Kelly air bladder cystoscope, which can also be used as a vaginal speculum with a bronchoscope or rhinoscope. Older girls can use a specially designed small vaginal duckbill instrument. Through the above speculum, one can clearly see the cervix and the situation of the vaginal epithelium and secretions, check for foreign objects, and at the same time, use a small cotton swab to take vaginal secretions for smears and Gram staining. Secretions can also be taken for culture and drug sensitivity testing, thereby determining the pathogenic bacteria.

　　3. Rectal and abdominal double-contrast examination

　　Use the left middle and index fingers to separate both sides of the large labia, insert the right index finger (if it is difficult to insert the index finger in smaller infants, you can also use the little finger) into the infant's anus and abdomen, and the other hand cooperate to touch whether there are foreign bodies in the vagina, the size of the uterus, and the pelvic situation. Rectal examination can also assist in obtaining vaginal secretions. The method is to push the posterior wall of the vagina forward with the finger in the rectum, and use a disinfected glass tube to suck the vaginal secretions while squeezing the rectum.

　　Pay attention to dietary nutrition in children with infantile vaginitis, eat more fresh vegetables and fruits to keep the bowels smooth. Drink more water to prevent urinary tract infections.

　　Taboo foods:

　　1. Avoid spicy foods:

　　Eating more can easily produce dry heat, causing internal organs to accumulate heat toxins, which can worsen symptoms.

　　2. Avoid seafood allergens:

　　It can help promote damp-heat, and after eating, it can make vulvar pruritus worse, which is not conducive to the regression of inflammation.

　　3. Avoid sweet and greasy foods:

　　It has the effect of moistening and increasing heat, which will increase the secretion of leukorrhea and affect the treatment effect.

　　The treatment methods for infantile vaginitis vary according to age. Pay attention to the hygiene of the perineum before treatment, keep it clean and dry to prevent infection.

　　First, Infancy

　　Use pure cotton diapers, and it is best not to use disposable diapers when not going out. Change diapers in time, and persist in cleaning the vulva 1-2 times a day, gently drying the labia minora and skin creases. When wiping, wipe the urethral opening, vaginal opening, and perianal area from top to bottom. If the skin is cracked, apply a non-irritating ointment. Finally, sprinkle talcum powder thinly and evenly on the vulva and inguinal area to keep it dry. Do not sprinkle too much powder to avoid the powder entering the vagina, forming small clumps and causing irritation.

　　Second, Infancy

　　Wear tight pants as soon as possible, wear loose cotton underwear, do not wear tight pants or synthetic knee-high socks. Clothes should be soft, loose, and comfortable to reduce friction. Pay attention to urination posture, and wipe the urethral opening and surrounding area with soft toilet paper after urination. Use clean toilet paper to wipe from front to back after defecation. Bathing basins, towels, etc. should be used by designated individuals. Wash clothes separately to reduce co-bathing and bathtub bathing.