Trichomonas vaginalis

Background

• Considered an STI
• A/w preterm birth, PID, cervical cancer, increased transmission of other STIs

Diagnosis

• Yellow, malordorous discharge
• Vaginal erythema or edema
• Wet mount shows mobile trichomonads

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

Treatment

• Treat sexual partners
• Metronidazole 2gm PO in single dose
• If pregnant d/w OB prior to TX, Flagyl associated with preterm labor
  • Metronidazole 500mg PO BID X 7d

See Also

• Vulvovaginitis

Source

Tintinalli