Trichomonas vaginalis

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/green, malodorous vaginal 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 24-hrs after last dose

Sexual Partner Treatment

Women with HIV Infection

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. Kissinger P et al. Single-dose versus 7-day-dose metronidazole for the treatment of trichomoniasis in women: An open-label, randomised controlled trial. Lancet Infect Dis 2018 Oct 5; [e-pub].
  3. CDC Trichomoniasis 2015. https://www.cdc.gov/std/tg2015/trichomoniasis.htm
  4. CDC. Sexually transmitted diseases treatment guidelines. MMWR Recomm Rep 2010;59(No. RR-12)
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