Do we need to treat vulvovaginitis in prepubertal girls?

Vulvovaginitis is generally considered to be the commonest gynaecological problem in prepubertal girls, although the incidence is unknown. In practice, the terms vulvitis, vaginitis, and vulvovaginitis are often used interchangeably by doctors in diagnosing inflammatory conditions of the lower female genital tract. Diagnosing infection is confounded by the overlap between normal flora and potential pathogens. The presence of an organism does not itself denote causation, and the clinical picture as well as microbiology should be considered before infection is assumed. 3 Despite vulvovaginitis being a common problem, the initial management is mostly empirical, and antibiotics are commonly prescribed. In this review, we present available evidence on the management of vulvovaginitis focusing mainly on the microbiology.