Red flags & when to go in person for Bacterial Vaginosis (BV) in Pediatrics

Audience: pediatric

Bacterial Vaginosis (BV) is a common vaginal infection caused by an imbalance of bacteria. It can cause symptoms like unusual discharge, odor, or discomfort. In children and adolescents, BV is less common but still possible. Telemedicine can help provide education, initial assessment, and guidance about BV symptoms. However, some signs mean you should see a healthcare provider in person promptly. These include severe pain, fever, unusual bleeding, or symptoms that worsen or do not improve with treatment. This guide helps families understand when telemedicine is appropriate and when in-person care is needed. It also explains what to prepare before a tele-visit and what to expect afterward. Remember, telemedicine advice is educational and not a substitute for a physical exam or lab tests that a doctor may need to diagnose and treat BV safely.

Red flags — go in person / ER

• Severe lower abdominal or pelvic pain requiring urgent medical evaluation
• Fever or chills indicating possible spreading infection
• Unusual or heavy vaginal bleeding not typical for age or menstrual cycle

What telemedicine can do

• Provide education about BV and its symptoms
• Assess symptom severity through patient history
• Advise on symptom management and hygiene
• Prescribe medication when appropriate and safe
• Guide when to seek in-person care

What telemedicine cannot do

• Perform physical pelvic examination
• Collect vaginal samples for laboratory testing
• Diagnose other conditions that mimic BV
• Manage severe or complicated infections
• Provide emergency care

What is Bacterial Vaginosis (BV)?

BV happens when the normal balance of bacteria in the vagina changes. This can cause symptoms like a thin, grayish discharge, a fishy smell, or mild irritation. BV is not a sexually transmitted infection but can be linked to sexual activity. It is less common in children before puberty but can still occur, especially in adolescents.

Common Symptoms to Watch For

Typical signs of BV include:

If these symptoms appear, telemedicine can help assess and guide next steps.

When to Seek In-Person Care Immediately

Certain symptoms need urgent evaluation by a healthcare provider in person:

These could signal a more serious infection or other health issues.

How Telemedicine Can Help

Telemedicine can provide:

However, telemedicine cannot perform physical exams or lab tests needed for a full diagnosis.

Preparing for Your Telemedicine Visit

Before your tele-visit:

This helps the healthcare provider understand your situation better.

What to Expect After Your Telemedicine Visit

After the visit, you may be advised to:

How to prepare for your tele-visit

• Write down all symptoms with start dates and changes
• List current medications and allergies
• Find a private, quiet place with good internet connection
• Ensure your device camera and microphone work
• Have a trusted adult available if needed for support

After your tele-visit

• Follow treatment instructions exactly as prescribed
• Watch for any worsening or new symptoms
• Maintain good personal hygiene and avoid irritants
• Schedule in-person follow-up if symptoms persist or worsen
• Contact healthcare provider promptly if red flag symptoms appear

FAQs

Can children get Bacterial Vaginosis?

While BV is more common in sexually active adolescents and adult women, it can occur in children, especially after puberty. If a child has symptoms, it is important to consult a healthcare provider to determine the cause.

Is Bacterial Vaginosis contagious?

BV is not considered a sexually transmitted infection, but sexual activity can influence the balance of bacteria in the vagina. It is caused by an imbalance of normal bacteria rather than a single contagious germ.

How is Bacterial Vaginosis treated?

Treatment usually involves antibiotics prescribed by a healthcare provider. It is important to complete the full course of medication even if symptoms improve before finishing the treatment.

Can telemedicine diagnose BV?

Telemedicine can help assess symptoms and provide guidance, but a definitive diagnosis usually requires a physical exam and lab tests, which need an in-person visit.

When should I seek emergency care for BV symptoms?

Seek emergency care if you experience severe pelvic pain, fever, heavy vaginal bleeding, or any sudden worsening of symptoms. These may indicate a serious infection needing urgent treatment.

Sources

1. Bacterial Vaginosis — MedlinePlus, U.S. National Library of Medicine.
2. Bacterial Vaginosis - CDC Fact Sheet — Centers for Disease Control and Prevention.
3. Bacterial Vaginosis — Mayo Clinic.
4. Bacterial Vaginosis Overview — Merck Manuals Consumer Version.

This telemedicine guidance is for educational purposes only and is not a substitute for in-person medical care. If you have concerning symptoms or red flags, please seek care from a healthcare provider in person promptly.