Trichomonas vaginalis

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Background

Wet mount of trichomonas. Note oval/pear shape with conspicuous flagella.
  • considered an STI
  • Associated with preterm birth, PID, cervical cancer, increased transmission of other STIs
    • inflammation of vaginal leads to increased HIV susceptibility [1]

Clinical Features

  • Yellow, malordorous discharge
  • Vaginal erythema or edema
    • "Strawberry Cervix" on speculum examination.

Differential Diagnosis

Vulvovaginitis

Sexually transmitted diseases

Evaluation

  • Wet mount shows mobile trichomonads

Management

Non-Pregnant

Pregnant

  • Only treat if the patient is symptomatic and avoid breast feeding until 24hrs after last Metronidazole treatment and 72hrs after Tinidazole
  • Metronidazole 2g PO once[2]

Sexual Partner Treatment

Women with HIV Infection

  • Metronidazole 500 mg PO BID x 7 days[3]

Disposition

  • Outpatient

See Also

References

  1. 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.
  2. CDC Trichomoniasis 2015. https://www.cdc.gov/std/tg2015/trichomoniasis.htm
  3. CDC. Sexually transmitted diseases treatment guidelines. MMWR Recomm Rep 2010;59(No. RR-12)