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There is some redness along with ulceration near vagina in a baby. Kindly advise.

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Patient's Query

Hello doctor,

My 4 years old daughter has redness around her vaginal wall. It looks as if it is an ulcer type or something. It hurts her a lot and frequent urination was there. We took her to pediatrician. He recommended us UTI course. Zocon and Tropan 2.5 mg was given. And Candid V gel is given. It has been 10 days. But still she complains of leg pain and pain near urethra. Should we go for sonography? Please let me know.

Answered by Dr. Atiqur Rahman Khan

Hello,

Welcome to icliniq.com.

I need more detail history from you, whether there is fever or burning micturition, or itching around vagina or any discharge from it. How is her behavior after these symptoms? As you have mentioned that there is 1 cut on vagina, how did this cut happen? Pain, burning or stinging when passing urine. Suspect pain if a young child starts to cry while passing urine.

The feeling of "cannot wait" to pass urine may occur. This is called urgency. Passing small amounts of urine at a time often. This is called frequency. New onset of day or night-time wetting. Pain in the lower tummy may also occur. If the kidney is infected, the pain is in the flank. The flank is the side right below the ribs. UTIs are a common cause of fevers without other symptoms in young children. The urine may be cloudy and have a bad odor. Sometimes, there is some blood in the urine.

The Probable causes

1. UTI on top of the list. 2. Interstitial cystitis. 3. Vulvovaginitis. 4. Trauma or injury. 5. Child abuse. The vulva is the area outside the vagina. Soaps can cause this area to be red, sore and itchy. This can lead to UTIs. Stool that gets on the vulva is another big factor. This can happen with careless wiping. It can also happen with constipation. A rare cause is if the bladder is not emptied all the way. Reason: Urine that stays in the bladder too long can become infected. Cystitis is more common in girls than boys. This is due to the much shorter length of the urethra in girls.

Investigations to be done

1. Urine RE (A clean catch urine sample needs to be tested. A UTI is confirmed by finding white blood cells in the urine. A positive culture for bacteria is also needed). 2. Repeat Urine c/s. 3. USG abdomen.

Differential diagnosis

1. UTI on top of the list.

2. Interstitial cystitis.

3. Vulvovaginitis.

4. Trauma or injury.

5. Child abuse.

Probable diagnosis

UTI on top of the list and vasico-uretric reflux or obstruction in urinary tract, interstitial cystitis, vulvovaginitis, trauma or injury. R/O child abuse (after proper examination and history).

Treatment plan

1. Education (clean from front to back) after defecation. 2. Plenty of oral fluids. 3. Cranberries drinks.

Preventive measures

Education (clean from front to back) after defecation plenty of oral fluids

Regarding follow up

Follow up after reports urine and usg pelvis and abdomen

Answered byDr. Atiqur Rahman Khan

Medically reviewed byDr. Divya Banu M

Published At May 18, 2020
Reviewed AtJanuary 22, 2024

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Dr. Atiqur Rahman Khan

Pediatrics

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