Distressing perineal and vaginal pain in prepubescent girls: an aetiology.

Aim: To propose an aetiology and treatment for distressing perineal and vaginal pain in a paediatric female population.

Methods: Between 1997 and 2011, we saw 24 prepubertal girls (mean age of seven years, 11 months) with distressing vaginal pain, both before and after we suspected that pinworms (Enterobius vermicularis) were the cause.

Results: Prior to 2005, two of six girls had resolution of their symptoms, one of whom had repeated courses of mebendazole. After 2005, when pinworms were discovered in one patient, treatment with mebendazole 100 mg weekly for three weeks resolved symptoms in 18 girls. Three girls had a recurrence of symptoms within 2-4 months, and repeat treatment with mebendazole was successful.

Conclusions: Pinworms should be considered when prepubertal girls present with distressing perineal or vaginal pain, and treatment with weekly mebendazole should be offered.