Recurrent Vulvovaginitis as an Unusual Presentation of Diagnosed Obstructed Hemivagina and Ipsilateral Renal Anomalies (OHVIRA) Syndrome in an Adolescent: A Case Report and Review of the Literature

TL;DR

A teenage girl with persistent vulvovaginitis was found to have a rare reproductive tract and kidney condition, which was resolved through surgery.

Contribution

This case highlights OHVIRA syndrome as a rare non-infectious cause of recurrent vulvovaginitis in adolescents.

Findings

Recurrent vulvovaginitis in a 16-year-old was caused by OHVIRA syndrome, not infection.

Surgical removal of the vaginal septum resolved symptoms completely.

Delayed diagnosis of Müllerian anomalies can harm reproductive health and quality of life.

Abstract

Background: Vulvovaginitis is a common condition in pediatric and adolescent female patients and is most frequently caused by infection. Although non-infectious etiologies are less common, they should be considered, particularly in cases that are refractory to standard treatment. Case: We report a rare case of a 16-year-old adolescent who was ultimately diagnosed with obstructed hemivagina and ipsilateral renal anomalies (OHVIRA) syndrome after experiencing recurrent vulvovaginitis for more than one year. Despite repeated antimicrobial treatments, her symptoms persisted. Further imaging studies revealed uterine didelphys with an obstructed hemivagina and ipsilateral renal agenesis. Surgical resection of the vaginal septum resulted in complete resolution of symptoms. Conclusions: Müllerian anomalies, such as OHVIRA syndrome, should be considered in the differential diagnosis for adolescents with recurrent vulvovaginitis refractory to conventional therapy. Delayed diagnosis may result in complications that significantly impair both quality of life and future reproductive potential.

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