Vulvitis, a-streptococcal vulvitis - Altmeyers Encyclopedia

Synonym(s)

A-streptococcal vulvitis; streptococcal vulvovaginitis

Definition
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A-streptococci are the main pathogens of vulvitis in prepubertal girls. The transmission takes place by digital smear infection from the nasopharynx. The colonisation of the child's nasopharynx with A-streptococci is estimated to be 3 - 10%. The child can also be a source of infection for the mother.

Manifestation
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Predominantly in prepubertal girls (80% of patients are 2-7 years old). In this age group this disease is the most common form of vulvitis. More rarely, A-streptococcal vulvitis occurs in adulthood. In this manifestation, an asymptomatic partner infection must be considered.

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Clinical features
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Acute, painful, burning redness and swelling of the vulva with extensive, whitish weeping epithelial detachments. Yellowish fluorine. More rarely, the picture of a dry scaling, flat redness of the vulva is more frequent.

Diagnosis
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To confirm the diagnosis, a smear with a moistened cotton swab is necessary for the cultural detection of streptococci.

Complication(s)
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In case of recurrent course, reinfections by simultaneous streptococcal pharyngitis are probable; furthermore, ascending infections are possible; puerperal sepsis; recurrent erysipelas.

Therapy
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The drug of choice is oral penicillin;

alternatively. Amoxicillin or cephalosporin.

Alternative: Clindamycinrine.

Duration of therapy: 5-10 days.

Literature
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Bray S et al,(2006) Two cases of group A streptococcal vulvovaginitis in premenopausal adults in a sexual health setting. Sex Health 3:187-188.
Clegg HW et al(2015) Clinical Perineal Streptococcal Infection in Children: Epidemiologic Features, Low Symptomatic Recurrence Rate after Treatment, and Risk Factors for Recurrence. J Pediatr 167:687-693.
Hansen MT et al(2007) Streptococcus pyogenes pharyngeal colonization resulting in recurrent, prepubertal vulvovaginitis. J Pediatr Adolesc Gynecol 20:315-317.
Heymann WR (2009) Streptococcal vulvovaginitis. J Am Acad dermatol 61:94-95.
Rahangdale L et al,(2008) Group A Streptococcus vulvovaginitis inbreastfeeding women. Am J Obstet Gynecol 199:e4-5.
Sobel JD et al(2007) Recurrent group A streptococcal vulvovaginitis in adult women: family epidemiology. Clin Infect Dis 44:e43-45.
Sonnex C (2013) Genital streptococcal infection in non-pregnant women: a case-note review. Int J STD AIDS 24:447-448.