Recurrent discharge (8 year old)

[medicalfish]

I posted this in Children's Health a few days ago, but am reposting here for traffic - I hope that's OK.

I've namechanged as this is very personal to my DD. Apologies in advance for the long post.

Over the course of about 15 months, DD8 has had recurrent bouts of vaginal discharge. They often (but not always) occur after she's been ill with something else, like a sore throat or vomiting bug. She has probably had 5 or 6 bouts of the discharge within the last 15 months.

She is a VERY long way from puberty - slightly built and no other signs of puberty at all. There is no suspected sexual abuse.

Each time the doctor has prescribed an antibiotic, and the discharge clears up. Unfortunately, she has had a negative reaction to two antibiotics (vomiting with one, and an awful rash with another), so now she can only take amoxicillin.

Twice (because of lockdown) I have had to swab her, which has been so unpleasant for her - and for me. The first swab showed Strep P (I had never heard of this). The second showed nothing in particular, other than pus - which is apparently what the discharge is.

The doctor said that because she had had so many infections (including an infected fingernail), he wanted her to see a paediatrician, who would likely order blood tests to rule out anything more worrying. I am assuming leukaemia etc.

I have waited five weeks for the referral to come through. Not the appointment - the actual referral. The doctors say they are chasing it, but I have heard nothing.

DD seems well in herself. She has had one more vomiting bug since going back to school but her appetite and energy levels are normal. She's quite a pale child, but nothing else worries me.

I did ask the doctor if they could do a blood test now to rule out anything more worrying but he said he wanted to wait for the paediatrician - but if we haven't even had notification of the appointment yet, I can't imagine it will be in the next few weeks.

We do have private insurance, but - as I said - DD seems well in herself, and hasn't even suffered from the discharge for at least 6 weeks. Apart from the vomiting bug, which she has totally recovered from, she is her normal self. Using private insurance would also have large cost implications for us in terms of excess plus insurance premium increases - we tend to keep it for "emergency" situations.

Would appreciate a medical opinion on whether I should:

a) try and insist the doctor does some bloods to rule out cancer markers
or anaemia

b) sit and wait

c) use private insurance to get her seen sooner.

C.

Are you sure they said strep p? And is the discharge a lot in quantity and does it itch or anything?

@EdwardCullensBiteOnTheSide

Are you sure they said strep p? And is the discharge a lot in quantity and does it itch or anything?

@EdwardCullensBiteOnTheSide They said Strep P. When I questioned, they said Streptococcus pyogenes.

She has no itch or pain at all. Her genitals look normal throughout. When the discharge is particularly bad, you can see it on the external of her genitals.

In terms of quantity, by the end of the day, it looks like my pants might look mid-cycle in terms of discharge on her knickers, or like you might expect from a pubescent girl. It's not soaking through her clothes or anything. It usually starts with a few spots, and after a few days, if untreated, looks as described above.

Apologies if this is TMI for those eating their dinner!

It sounds like vulvovaginitis op and I don't think antibiotics are recommended for that? Does she shower regularly or bath? I think I'd try getting her to have a nightly sit in a salt bath for five mins or so, and make sure she goes easy on soaps (or just doesn't use soaps at all in that area)
I personally had loads of problems like this when I was younger and I never suffer now.

Also my sisters little girl started suffering with it age 6.

She has a bath every night, but just plain water, and washes with plain soap.

She doesn't get any soreness or swelling. I can't comment on the suitability of treatments she's been given other than to say that when she has had antibiotics (apart from those she's reacted to), it does clear up for a matter of weeks.

Part of me is reluctant to "jump the queue" using private health insurance because at the minute, she's perfectly well, no discharge etc. And part of me is worrying there is something systematic going on that needs a diagnosis sooner rather than later.

Hi. My daughter had recurring bouts of excess discharge, usually accompanied by a sore throat or a virus etc at around age 7- 8. She had to wear a panty liner for school which required changing! I took her to the doctors and she had courses of antibiotics and a swab also came up with an infection which I think was strep but I can't remember with absolute certainty. The doctor wasn't worried. My daughter just seemed to grow out of it and is totally fine now x

A few years ago I discovered a lump in my 4 year olds neck. The Dr was very dismissive and said it was likely due to a virus and would go away in a few weeks. I went away and then thought, hang on a minute, my child's life is in my hands here! I phoned the surgery and told them I at the very least wanted a blood test for him and I wasn't going to stop asking until they did one. They called me back with an appointment for a blood test at the hospital that same day. I think if you feel there is something going on op you need to stamp your feet a little bit. A Blood test isn't going to break or overwhelm the NHS.

@BlueStargazer

Hi. My daughter had recurring bouts of excess discharge, usually accompanied by a sore throat or a virus etc at around age 7- 8. She had to wear a panty liner for school which required changing! I took her to the doctors and she had courses of antibiotics and a swab also came up with an infection which I think was strep but I can't remember with absolute certainty. The doctor wasn't worried. My daughter just seemed to grow out of it and is totally fine now x

@BlueStargazer Thank you, that's really reassuring. I've Googled and Googled but there's not much out there about this, but at least two people on this thread have had DDs aged 6-8, which gives me some reassurance it's not completely abnormal.

@EdwardCullensBiteOnTheSide I think you're right. Maybe I'll give it one more week for the paediatric referral and then insist upon a blood test. Hope all turned out well with your DS.

I don't think it will be anything to worry about. Your daughter is otherwise healthy and I don't think a bit of discharge is a problem for little girls. We saw a female doctor who really wasn't worried about the discharge. When I was reading your post it sounded exactly the same as with my daughter. X