Can a 5-year-old girl have a urinary tract infection cured? Urinary system: I don't carry this pot

time:2022-11-27 author:Make one's mouth water
Can a 5-year-old girl have a urinary tract infection cured? Urinary system: I don't carry this pot

*For medical professionals to read for reference Does an increased white blood cell count mean a urinary tract infection? Let's look at a case first. Outpatient case This is a 5-year-old girl admitted to the outpatient department of our hospital. She came to the outpatient clinic because of dysuria. The routine urine examination showed that the white blood cells were 3+, and the white blood cell count was 48.9/ul. Considering urinary tract infection, she was given oral treatment with cefixime. After 1 week of treatment, the symptoms of the child did not improve significantly, and the parents brought the child for a follow-up visit. The urine routine showed that the white blood cell was 3+, and the white blood cell count was 117.1/ul. Why after oral antibiotic treatment, urine routine shows increased white blood cell count instead? With doubts, I carefully asked the medical history. The child complained of burning pain in the vulva when urinating, and the mother suffered from bacterial vaginosis, but the child's underwear was washed separately. A careful physical examination revealed that the skin and mucous membranes of the vulva of the child were red, mildly edema, and a small amount of yellow secretions were seen on the underwear without foul odor. Therefore, it was recommended that the child go to the gynecological clinic of our hospital for treatment, and the vaginal secretion test showed that the sialidase test of bacterial vaginosis was positive, and the possibility of bacterial vaginosis was considered. Her condition improved after treatment with skin medicine lotion and sitz bath and oral antibiotic cefuroxime. Case inspiration Through this case, we learned that if we encounter a girl with urinary tract irritation clinically, in addition to considering urinary tract infection, we also need to consider the possibility of vulvovaginitis to avoid misdiagnosis. Let's learn more about vulvovaginitis in children. Pediatric vulvovaginitis is a common genital inflammation in children, accounting for about 40% to 50% of pediatric gynecological outpatient cases. Due to the special physiological characteristics of children, the etiology, clinical manifestations, treatment and prognosis of vulvovaginitis in children are different from those in adults. The etiology is because the anatomical and physiological structure of prepubertal women is different from that of adults:
  • Poor development of the vulva, lack of fat pads and pubic hair, small and thin labia, little protection of the vestibule, and poor defense ability;
  • Low estrogen level in the body, thin vaginal epithelium, neutral or alkaline vaginal pH (6.0-8.0), which is conducive to the growth of pathogenic microorganisms;
  • The anus is close to the vagina, urine and feces Easy to contaminate the local area.
Therefore, poor hygiene habits, fecal contamination or pinworm infection all make children prone to vulvovaginitis. In addition, some parents do not know enough about vulvovaginitis in children, delay diagnosis and treatment after the onset or parents handle it by themselves, which also leads to the frequent occurrence of vulvovaginitis in children. Clinical manifestations The incidence of vulvovaginitis in children aged 3 to 7 years is the highest. Most of the clinical manifestations are:
  • The skin and mucous membranes of the vulva and vestibule of the vagina are red, mildly edema, and there is increased secretion, which is thin, purulent or light bloody, and the underwear may be stained or even crusted , or smell or stench;
  • Children often have symptoms such as pain, itching, burning, restlessness, crying, etc.; Symptoms, such as dysuria, urination disturbance, urgency, and frequent urination.
Laboratory examinations are mainly the detection and culture of vaginal secretions. The incidence of vulvovaginitis in children is mainly related to infection. Different from adults, specific infections such as Trichomonas, Candida, and Neisseria gonorrhoeae are relatively low. The most common pathogens are bacteria, mainly Haemophilus influenzae, Streptococcus pyogenes, and Escherichia coli bacteria etc. Diagnosis is easy to diagnose through local observation and routine laboratory tests, combined with the symptoms and signs of children. However, in order to find out the pathogen and facilitate treatment, it is necessary to carefully ask the medical history, general examination and special laboratory examinations. The treatment of vulvovaginitis in children is mainly based on the application of antibiotics. The problem of bacterial resistance caused by the widespread application of antibiotics has become a major problem in the treatment of vulvovaginitis in children. Early detection, early diagnosis and early treatment, as well as rational use of antibiotics are necessary measures. Several major pathogens are generally resistant to penicillins and cannot be selected in clinical practice. drug of choice. Vulvovaginitis caused by specific pathogens should be treated against the pathogen. Candidal vaginitis gradually changed the traditional alkaline solution, and used acid solution for treatment, because the effect of acid solution on vaginal pH value can significantly increase the local bioavailability of clotrimazole. In addition, white, slippery physiological leucorrhea increases before puberty, and there may be yellow-brown stains on the underwear of those with a large amount, which is a normal phenomenon and does not require treatment. For mild children with symptomatic treatment, sitz bath is a good method. To prevent vulvovaginitis in children, non-specific vulvovaginitis is more common, and the pathogens are mostly opportunistic pathogens. Therefore, maintaining good hygiene habits is the key to preventing the occurrence of this disease. Parents should pay attention to the child’s vulva cleaning, wash the vulva with clean water every 2-3 days, change the children’s underwear every day, and after defecation, parents should pay attention to wiping from front to back to avoid feces contaminating the vulva; the washing utensils used by the parents should be separated from the children’s. , to avoid cross-infection in children; in childhood, try to wear cotton underwear that is not too tight, and clothes should be soft, loose, and comfortable to reduce friction with the body; Delay in diagnosis and treatment. References: [1] Shi Yifu. Pediatric and adolescent vulvovaginitis [J]. China Family Planning and Obstetrics, 2019, 11(12): 5-7. [2] Gao Kaijie, Yang Junwen, Fang Panpan , Zhou Juanjuan, Zhang Dongyu, Wang Fang, Yang Junmei. Analysis of pathogenic bacteria and drug resistance in 319 children with vulvovaginitis [J]. Chinese Journal of Antibiotics, 2021, 46(10): 958-963. [3] Zhu Yanfei. 96 cases of children with vulva Clinical analysis of vaginitis[J].China Maternal and Child Health,2010,25(30):4480-4481.[4]Jin Jian. Nursing care of children with vulvovaginitis[J].Everyone Health (Academic Edition),2015,9( 13): 223. This article was first published: Pediatrics Channel of the Medical Community Author of this article: Tian Mingda Wu Jun, Pediatrics Department of Peking University Shougang Hospital Editor in charge: Xiang Yu, all the pediatric clinical knowledge doctor station apps you want to see 👇 1. Scan the QR code below 2 .Click "Download Now" to download the Doctor Station App, and subscribe anytime, anywhere~ Copyright Statement This article is original and welcome to forward it to Moments - End - The medical community strives for the accuracy and reliability of its published content when it is approved, but it does not regard the timeliness of the published content. , and the accuracy and completeness of the cited information (if any), and does not assume any responsibility for the outdated content, possible inaccuracies or incompleteness of the cited information. Relevant parties are requested to check separately when adopting or using it as a basis for decision-making.
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