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Old 09-07-2012
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Arrow Gyrus Daily Questions; Pediatrics #17

The mother of a 2-year-old girl reports that her daughter complains
of burning when she urinates and that she has foul-smelling discharge from
her vagina. She has noticed that there is some slight staining on the front of
her underwear, but she reports no fever, nausea, vomiting, or other constitutional signs. The child does not attend day care, and she has demonstrated no change in behavior. The physical examination is normal with an intact hymen, but the child’s vulva is reddened and with a malodorous
scent noted. Her urinalysis and culture are normal. The most likely explanation
for this child’s condition is

a. Sexual abuse
b. Pinworms in the vagina
c. Chemical vulvovaginitis
d. Pediculosis pubis
e. Giardiasis
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Old 09-07-2012
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Answer A .she has got STD -foul smelling discharge
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b. Pinworms in the vagina
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i think B...pinworm can cause vulvo-vaginitis......
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B) Pinworms

Young girls are stupid and clean themselves from the BACK towards the FRONT
she essentially contaminated herself

diagnosis is with scotch tape test
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Quote:
Originally Posted by cingulate.gyrus View Post
The mother of a 2-year-old girl reports that her daughter complains
of burning when she urinates and that she has foul-smelling discharge from
her vagina. She has noticed that there is some slight staining on the front of
her underwear, but she reports no fever, nausea, vomiting, or other constitutional signs. The child does not attend day care, and she has demonstrated no change in behavior. The physical examination is normal with an intact hymen, but the child’s vulva is reddened and with a malodorous
scent noted. Her urinalysis and culture are normal. The most likely explanation
for this child’s condition is

a. Sexual abuse
b. Pinworms in the vagina
c. Chemical vulvovaginitis
d. Pediculosis pubis
e. Giardiasis

b.) pinworms in the vagina?
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Quote:
Originally Posted by XpaezX View Post
B)
Young girls are stupid and clean themselves from the BACK towards the FRONT
she essentially contaminated herself
It's not because of that reason.
It's because pinworms migrate at night from anus and enter vagina and essentially acts as foreign bodies causing superinfection leading to foul smelling discharge.
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Quote:
Originally Posted by XpaezX View Post
B) Pinworms

Young girls are stupid and clean themselves from the BACK towards the FRONT
she essentially contaminated herself

diagnosis is with scotch tape test
hahahahaha......like it .....seems like u have a good observation.... ....
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Answer is

The answer is c.
The symptoms listed are those of vulvovaginitis, with nonspecific (or chemical) vulvovaginitis accounting for 70% of all pediatric vulvovaginitis cases.

The discharge in nonspecific vulvovaginitis is usually brown or green and with a fetid odor. The burning with urination occurs because of contact between raw skin and urine.

Further history in this case might reveal use of tight-fitting clothing (including rubber pants), prolonged bubble baths with contamination of the vagina with soap products, use of perfumed lotions in the vaginal area, or improper toilet habits (wiping of fecal material toward rather than away from vagina).
Attention to these causative conditions usually results in resolution of the symptoms.

The finding of a normal hymen points away from sexual abuse.

Pinworms can infest the vagina, but symptoms usually include significant itching of the rectum and vagina.

Pediculosis pubis requires pubic hair and, thus, is usually not seen before
adolescence. Giardiasis can result in vaginal discharge, but associated symptoms usually include diarrhea and malabsorption syndrome as well. In a sexually active adolescent (or in a sexually abused younger child) a variety of
infectious agents such as candida, Chlamydia trachomatis, Trichomonas vaginalis, Gardnerella vaginalis, and Neisseria gonorrhoeae would be higher on the differential.
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Quote:
Originally Posted by K06100 View Post
hahahahaha......like it .....seems like u have a good observation.... ....

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