Genital Tract Infections - Trichomoniasis

Question 1

What is Trichomonas Vaginalis?

Answer 1

A single-celled flagellated (4 anterior and 1 posterior) protozoan parasite spread through sexual intercourse.

Question 2

Where can Trichomonas be found? (3).

Answer 2

1. Men : Urethra.
2. Women : Urethra.
3. Women : Vagina.

Question 3

Clinical Presentation of Trichomoniasis.

Answer 3

1. 50% Asymptomatic.
2. Non-Specific Symptoms : Vaginal Discharge, Itching, Dysuria, Dyspareunia, Balanitis.
3. Vaginal Discharge : Frothy Yellow-Green with Fishy Smell.
4. Men : Asymptomatic / Urethritis.

Question 4

Investigations of Trichomoniasis.

Answer 4

1. Cervix Examination.
2. Vaginal pH > 4.5 (like Bacterial Vaginosis).
3. Diagnosis : Standard Charcoal Swab with Microscopy.

Question 5

Examination Findings of Trichomoniasis.

Answer 5

‘Strawberry Cervix’ - Colpitis Macularis - cervicitis resulting in tiny haemorrhages across the surface.

Question 6

Where should swabs be taken from?

Answer 6

1. Women : Posterior Fornix of Vagina (or Self-Taken Low Vaginal Swab).
2. Men : Urethral Swab (or 1st Catch Urine).

Question 7

Microscopy Finding of Trichomoniasis.

Answer 7

Motile Trophozoites.

Question 8

Management of Trichomoniasis.

Answer 8

1. GUM Referral - Diagnosis, Treatment and Contact Tracing.

2. Oral Metronidazole 5-7 Days.

Question 9

Complications of Trichomoniasis (5).

Answer 9

1. Contracting HIV - Damaged Vaginal Mucosa.
2. Bacterial Vaginosis.
3. Cervical Cancer.
4. Pelvic Inflammatory Disease.
5. Pregnancy-Related Complications e.g. Pre-Term Delivery.