she is a 9 yrs old girl. has dese genital lesions fr abt 5 yrs. lesions r vry itchy n foul smelling. d whitish layer can not b wipped/removed n in doin so she has severe pain. no lesions anywhr in body, no burning micturition. as per her mother she had h/o urinary incontinence (dribblin of urine aftr completion of micturition) bt presently she is continent. she has been takin treatment fr it since its appearance bt nvr got fully relieved. she has no medical history of chronic disease. no sexual abuse history. dd n treatment??

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White curdy lesions with severe itch in the both sides of the labia with fowl smell discharge with dribbling of urine more favour to CANDIDAL VAGINITIS with recurrent UTI. Do cultural sensitivitiy of this case prescribe antibiotic according to the SENSITIVITY. For curdy lesions Antifungal douches Tab Fluconazole 400 mg Tab Azithromycin 1 g And metronidazole combination kit once for every 3 days for 3 times and followed by CANDIDAL vaginal gel. Daily night keep the affected part into lukewarm water and added salt for 15 mts and apply gel. Tab levocetrizine 10 mg daily night to combat the itching.

Truly it is candidal vaginitis Rx as advised by Dr.P.Kishore Kumar
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The lesions for last 5 years ,p/h/o urinary incontinence and lesions are very itchy and foul smelling , treatment for last 5 years without fully relieved ( good quality images says, not relieved at all, at present ; suggests that it's a polymicrobial infection, most likely aerobic, facultative anaerobes , strict nonsporing anaerobes (likely to be responsible for foul smell ) , ? Slime producing bacteria, yeast like fungi and other fungi causing superficial / cutaneous fungal infection - are responsible for this suffering for last 5 years. This case really need thorough work up before putting her on specific medications. Otherwise, putting on emperical medications , suggested by different specialist , will be useless, invite resistance to antifungals, if not already resistant. And it will take another 5 years to arrive at specific diagnosis and treatment guidelines from different tests which should be done on priority basis, Till then symptomatic treatment may be given along with maintenance of good practice on personal hygiene.

Vulvovaginal candidiasis with secondary infection.Continuous wetting of the vulvovaginal area causing fungal and bacterial infection.T.Fluconazol 150 mg wkly for 4wks.T.Metrogyl 400mgs tid for 1 wk.Candid or onabet skin cream for local application thrice a day.Vulval wash with intiwash and maintaining local hygiene.Urine for c/s. Keeping the area dry.If dribbling of urine continues consult the urologist.

It is Valval infection Could be bacterial or fungal It should be treated with higher antibiotic in full therapeutic course as par cause With due hygenic care. H/O incontinence of urine Does it is scrutinise for cause ? - Mental ( neurogenic) - Physcogenic - chronic Urinary tract infection Continuous dribbling of urine aggravating existing vulval infection & excoriation ultimately tremendous burning sensation to itchy vulval skin * So rule out cause for incontinence * Apply Xyocaine jelly along with antibacterial / antifungal ointment. * Hygenic care ...too

Do hcv, vdrl, urine c/s Its vuvlovaginal candidiasis w/ secondary infection. One tri can kit for three days once for three times. If pruritus give metrogyl. Tab allegra 180mg 0-0-1/2 for 10days. Candidal vaginal gel for application.

Candidal vaginitis

Vulvovaginal candidiasis

? Scabies with recurring bact.infection / Candidial infection

Dr Ranjit Kumar Poriya Homeopathy 9yrs old girl Case History Basis Diagnosis Imp Vaginitis Infection. Rx Acid Nit 30Xbd X7day. * Kreojotum 200 Weekly 1dose X1month =4dose. * External Surfaz SN Oint May be Helpful. * Every Night Wash Savlon Lotion. with Light Hot water. After use Surfaz oint.

Looks like infecited Bertholin cyst, probably bilateral again &again rptures and causing excoriation, under anaesthesia needs go be removed, preop and postop Antibiotics wd be reqd

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