Chapter 4 – The Vagina and Vulva

Group A streptococcus

Group A beta haemolytic streptococcus can cause low grade persistent vulval and perianal rash or acute vulvovaginitis in pre-pubertal children. It is virtually never seen in the adult vagina.

Streptococcal vulvovaginitis presents with sudden onset of a red, swollen painful vulva and vagina and may have an associated discharge. There may be a history of preceding throat infection as the organism is believed to reach the vagina by haematogenous spread from the throat.

Diagnosis is made by taking a skin swab of the vulva. It is not necessary to insert the swab into the vagina.

Treatment is with oral penicillins or cephalosporins based on antibiotic sensitivity testing. A 10 day course is recommended.

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