Published: 2017-02-23

Aetiology of vaginal discharge in children

Parimalam Kumar, Suguna K., Lavanya P.


Background: Vaginal discharge [VD] is the most common gynecologic complaint in children. The causes vary from being physiological to sexually transmitted diseases. The anatomy and physiology of the vulva and vagina and the vaginal flora influence the causes to some extent. As the above factors vary as the child grows, the etiology varies too. At any age, VD is responsible for a significant morbidity. Hence enumerating the causes and identifying the common causes in specific age groups will help in development of preventive measures and early appropriate treatment. The aim of the study was to enumerate the cause of VD in children attending the OPD at Government Royapettah Hospital and to find out the causes of VD in specific age groups less than 2 year, 2-9 years and 9-14 years.

Methods: A retrospective analysis of twenty girls less than 14 years of age with VD details were collected from the STI cards of twenty children in the age group upto 14 years, with vaginal discharge, who attended the STI clinic at GRH, KMC will be selected and their symptoms, clinical examination findings, results of relevant investigations noted from their hospital records. Children with HIV infection, immunosuppression due to juvenile diabetes mellitus/ malignancy and history of sexual abuse will be excluded. The results tabulated and a descriptive analysis done to find out the most common aetiology in different age groups in children. Descriptive analysis was applied to analyse the results.

Results: Out of the twenty children studied 40, 10, 50 percent of the girls were in group A, B and C respectively. Youngest child was 6 months old and oldest was 14 years.  In 10% of girls the incidence of VD was physiological and in 90% it was due to pathological causes. In 50% of children the causative agent could be demonstrated by laboratory investigations. Candida was the commonest agent demonstrated in 25% of girls studied. In 35% cases the cause was unidentifiable. Bacterial, parasitic and dermatological causes constituted to 10%, 15%, 10% of aetiology of VD respectively. In one child [5%] who had genital psoriasis, the clinical features of candidal infection was negative.

Conclusions: Aetiological diagnosis was very important in children with VD. Not all VD in children are infective and hence anti-fungal and anti-bacterial agents should not be prescribed without adequate clinical and or microbiological evidence. Pin worm infestation should be considered as a cause of VD in girls with perianal excoriation and nocturnal worsening of symptoms.



Vaginal discharge, Children, Prepubertal

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Hayes L, Creighton SM. Prepubertal vaginal discharge. TOG. 2007;9(3):159-63.

McGreal S, Wood P. Recurrent vaginal discharge in children. J Pediatr Adolesc Gynecol. 2013;26(4):205-8.

Jaquiery A, Stylianopoulos A, Hogg G, Grover S. Vulvovaginitis: clinical features, aetiology, and microbiology of the genital tract. Arch Dis Child. 1999;81(1):64–7.

Kim H, Chai SM, Ahn EH, Lee M-H. Clinical and microbiologic characteristics of vulvovaginitis in Korean prepubertal girls, 2009–2014: a single center experience. Obstet Gynecol Sci. 2016;59(2):130–6.

Emans Laufer Goldstein S Pediatric And Adolescent Gynecology. Available at: Accessed on 10 January 2016.

Bumbulienė Ž, Venclavičiūtė K, Ramašauskaitė D, Arlauskienė A, Bumbul E, Drąsutienė G. Microbiological findings of vulvovaginitis in prepubertal girls. Postgrad Med J. 2014;90(1059):8–12.

Pierce AM, Hart CA. Vulvovaginitis: causes and management. Arch Dis Child. 1992;67:509–12.

Cox RA, Slack MP. Clinical and microbiological features of Haemophilus influenzae vulvovaginitis in young girls. J Clin Pathol. 2002;55:961–4.

Yilmaz AE, Celik N, Soylu G, Donmez A, Yuksel C. Comparison of clinical and microbiological features of vulvovaginitis in prepubertal and pubertal girls. J Formos Med Assoc. 2012;111(7):392–6.

Thomas A, Forster G, Robinson A, Rogstad K. For the Clinical Effectiveness Group (Association of Genitourinary Medicine and the Medical Society for the Study of Venereal Diseases). National guideline for the management of suspected sexually transmitted infections in children and young people. Sex Transm Infect. 2002;78:324–31.

Makwela MR. Paediatric vaginal discharge. SA Fam Pract. 2007;49(7):30-1.

Joishy M, Ashtekar CS, Jain A, Gonsalves R. Do we need to treat vulvovaginitis in prepubertal girls? British Med J. 2005;330(7484):186–8.

Stricker T, Navratil F, Sennhauser FH. Vulvovaginitis in prepubertal girls. Arch Dis Child. 2003;88:324–6.

Slupik R. Pediatric gynecology, Clinical gynecology. In: Sciarra J, editor. Gynecology and Obstetrics. Philadelphia: Lippincott Williams & Wilkins; 1991: 1-19.