Table 1

Causes of vaginal discharge in prepubertal girls

Oestrogen deficiencyThin skin, lack of cornification, alkaline pH
Poor hygiene practicesFaecal contamination due to wiping the bottom forwards
Faecal contamination from soiled underwear
InfectionSexually transmitted infections (eg, gonorrhoea, chlamydia, Trichomonas vaginalis)
Other bacteria (eg, Haemophilus influenza, Staphylococcus aureus, anaerobes, streptococci)
Fungal infection (eg, candida albicans)
Viral infection (eg, herpes simplex)
Local irritantsBubble bath, synthetic underwear, allergies to soaps
Constipation with soilingLeakage of faeces leading to irritation or infection
DermatitisEczema, psoriasis, lichen sclerosis
Foreign body
Sexual Abuse
Anatomical anomaliesDouble vagina with fistula, ectopic ureter
Rare causesCrohn’s disease with fistula, pelvic abscess, tumours (eg, lymphangioma, sarcoma botryoides)