Trichomonas vaginalis: Difference between revisions
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==Background== | ==Background== | ||
* | [[File:Trichomonas.jpg|right|thumbnail|Wet mount of trichomonas. Note oval/pear shape with conspicuous flagella.]] | ||
* | *''Is'' considered an [[STI]] | ||
**Most cases are asymptomatic (in both men and women). | |||
**May persist for months to years in infected patients, thus making it difficult to identify whether a patient’s last sexual partner is the source of the infection. | |||
*Associated with preterm birth, [[PID]], cervical cancer, increased transmission of other [[STIs]] | |||
**inflammation of vaginal leads to increased [[HIV]] susceptibility <ref>Mavedzenge SN, Pol BV, Cheng H, Montgomery ET, Blanchard K, de Bruyn G, Ramjee G, Straten Av. Epidemiological synergy of Trichomonas vaginalis and HIV in Zimbabwean and South African women. Sex Transm Dis. 2010 Jul;37(7):460-6. doi: 10.1097/OLQ.0b013e3181cfcc4b. PubMed PMID: 20562586. </ref> | |||
== | ==Clinical Features== | ||
*Yellow, | *Yellow/green, malodorous [[vaginal discharge]] | ||
*Vaginal erythema or edema | *Vaginal erythema or edema | ||
**"Strawberry Cervix" on speculum examination. | |||
==Differential Diagnosis== | |||
{{Vulvovaginitis DDX}} | |||
{{STD DDX}} | |||
==Evaluation== | |||
*Wet mount shows mobile trichomonads | *Wet mount shows mobile trichomonads | ||
== | ==Management== | ||
{{Trichomonas antibiotics}} | |||
== | ==Disposition== | ||
* | *Outpatient | ||
==See Also== | ==See Also== | ||
*[[Vulvovaginitis]] | *[[Vulvovaginitis]] | ||
== | ==References== | ||
<references/> | |||
[[Category:OBGYN]] | |||
[[Category: | |||
[[Category:ID]] | [[Category:ID]] | ||
Latest revision as of 22:00, 5 June 2024
Background
- Is considered an STI
- Most cases are asymptomatic (in both men and women).
- May persist for months to years in infected patients, thus making it difficult to identify whether a patient’s last sexual partner is the source of the infection.
- Associated with preterm birth, PID, cervical cancer, increased transmission of other STIs
Clinical Features
- Yellow/green, malodorous vaginal discharge
- Vaginal erythema or edema
- "Strawberry Cervix" on speculum examination.
Differential Diagnosis
Vulvovaginitis
- Bacterial vaginosis
- Candida vaginitis
- Trichomonas vaginalis
- Contact vulvovaginitis
- Bubble baths and soaps
- Deodorants, powders, and douches
- Clothing
- Atrophic vaginitis due to lack of estrogen (AKA Vulvovaginal atrophy)
- Lichen sclerosus
- Tinea cruris
- Chlamydia/Gonorrhea infection
- Pinworms
- Vaginal foreign body
- Toilet paper
- Other
- Genitourinary syndrome of menopause
- Foreign body
- Allergic reaction
- Normal physiologic discharge
Sexually transmitted diseases
- Chancroid
- Chlamydia trachomatis
- Granuloma inguinale
- Hepatitis B
- Herpes Simplex Virus-2
- HIV
- Human papillomavirus
- Lymphogranuloma venereum
- Neisseria gonorrhoeae
- Trichomonas
- Syphilis
Evaluation
- Wet mount shows mobile trichomonads
Management
Non-Pregnant
- Metronidazole 500mg PO BID for 7 days [2]
- Tinidazole 2g PO once
Pregnant
Only treat if the patient is symptomatic
- Metronidazole 500mg PO BID for 7 days [3]
Sexual Partner Treatment
- Female: Same as above
- Male: Metronidazole 2 gm PO x1 [4]
Disposition
- Outpatient
See Also
References
- ↑ Mavedzenge SN, Pol BV, Cheng H, Montgomery ET, Blanchard K, de Bruyn G, Ramjee G, Straten Av. Epidemiological synergy of Trichomonas vaginalis and HIV in Zimbabwean and South African women. Sex Transm Dis. 2010 Jul;37(7):460-6. doi: 10.1097/OLQ.0b013e3181cfcc4b. PubMed PMID: 20562586.
- ↑ Workowski KA, Bachmann LH, Chan PA, et al. Sexually Transmitted Infections Treatment Guidelines, 2021. MMWR Recomm Rep 2021;70(No. RR-4):1–187. DOI: http://dx.doi.org/10.15585/mmwr.rr7004a1external icon
- ↑ CDC Trichomoniasis 2021. https://www.cdc.gov/std/treatment-guidelines/trichomoniasis.htm
- ↑ Workowski KA, Bachmann LH, Chan PA, et al. Sexually Transmitted Infections Treatment Guidelines, 2021. MMWR Recomm Rep 2021;70(No. RR-4):1–187. DOI: http://dx.doi.org/10.15585/mmwr.rr7004a1external icon