Mornlng 8eporL

Adam Ware
C?2
ecLlve
W Chlef ComplalnL
vaglnal lLchlng paln for 1 monLh wlLh 2 weeks of
dlscharge
W Pl
revlosly healLhy 11 yo female wlLh 1 monLh hlsLory
of vaglnal lLchlng and paln rogresslvely worsenlng
2 weeks ago noLlced small amonL of whlLe mcs"
dlscharge ln nderwear no lood Cccrs dally Lo
CCu
lnLermlLLenL rnlng" paln Cccaslonal dysrla
Pas noL reached menarche
ecLlve
W Pl ConL
ueny Lrama
ueny concern for sexal ase
lamlly has noL glven any LreaLmenLs
no new soaps or deLergenLs uoes Lake le
aLhs
no LlghL cloLhlng
no fevers
no recenL lllnesses
ecLlve
W asL Medlcal PlsLory
lll Lerm no hosplLallzaLlons no srgerles
W MedlcaLlons
none
W Allergles
none
ecLlve
W oclal PlsLory
arenLs are dlvorced Llves wlLh moLher aL home
laLher llves oL of sLaLe Cnly chlld ALLends 6
Lh
Crade leels safe aL school leels safe aL home
uenles any sexal acLlvlLy or ase
W lamlly PlsLory
1ype 2 uM ln MaLernal grandmoLher
rosLaLe cancer paLernal grandfaLher
ecLlve
W 8evlew of ysLems
oslLlves vaglnal lLchlng dlscharge paln dysrla
negaLlves lever acLlvlLy or appeLlLe change
recenL lllness headache welghL loss adomlnal
paln dlarrhea consLlpaLlon nasea vomlLlng
adenopaLhy rash
CecLlve
W vlLal lgns
WelghL 63 kg (97
Lh
lle)
PelghL 137 cm (96
Lh
lle)
8Ml 26 (97
Lh
lle)
1 369 P8 96 8 118/70 88 18
W hyslcal Lxam
CLnL8AL Large sllghLly overwelghL female conversaLlonal noL dlsLressed
PLLn1 nC/A1 no conncLlvlLls no pharyngeal eryLhema/exdaLe no rhlnorrhea no
adenopaLhy
Cv 888 no mrmrs 2+ plses cap reflll 2 seconds ln exLremlLles
uLM C1A8 good aeraLlon
Ad ofL noL Lender noL dlsLended no masses no paln over lower qadranLs
Cu 1anner 1 LryLhema of lala llaLerally worse eLween maora and mlnora canL whlLe
dlscharge wlLh fol odor Pymen open wlLh Lhln rlm from 8 Lo 4 no rlslng leedlng or
veslclar skln leslons Ans normal
Lx1 no edema no cyanosls
nuL8C Crossly lnLacL
ln er Cu exam CLherwlse no rashes lrLhmarks or leslons
ulfferenLlal ulagnosls
Las
W urlnalysls pec Crav 1030 1+ lood
W urlne ClLre negaLlve
W Crop A sLrep ClLre negaLlve
vlvovaglnlLls
W nonspeclflc
Cases 23 73 of cases
8lsk facLors anaLomy nesLrogenlzed mcosa
alkallne pP hyglene oeslLy cloLhlng
1reaLmenL
W Avold sleeper" paamas LlghL cloLhlng le aLhs
perfmed soaps
W Lncorage coLLon nderwear slLz aLhs approprlaLe
hyglene cool compresses weL wlpes
Conslder remarln
lmprovemenL ln 23 weeks
vlvovaglnlLls
W CLher aLhogens
lnworms (recrrence worse aL nlghL)
Candlda (34 dlapers recenL ax lC)
Cardernella vaglnalls
W exally 1ransmlLLed lnfecLlons
Conorrhea
Chlamydla
1rlchomonas
Pv
Perpes
vlvovaglnlLls
W CLher
lorelgn ody
W 8emoval AnesLheLlze lnLrolLs (LMLA/xyloclane)
W Calgl swa or lrrlgaLlon
olyps/1mors
W 8hadomyosarcomas arcoma oLyroldes
W 8ecrrenL sympLoms
W 8efer Lo gynecology
AnaLomlc
W LcLoplc reLer (chronlc weLness u1l)
W ureLhral prolapse
W ApLhos lcers