Trichomonas vaginalis Flashcards
What type of organism is trichomonas vaginalis?
Flagellated protozoan parasite
What is the route of transmission of trichomonas vaginalis?
Sexually transmitted
What are the clinical features of trichomoniasis?
Redness and swelling of vulva and vagina (vulvovaginitis)
Redness sometimes extends out onto labia majora and adjacent skin
Purulent green or yellow discharge
Strawberry cervix
What causes the cervix to appear like a strawberry in trichomoniasis?
Punctate haemorrhages
What colour is the discharge associated with trichomoniasis?
Yellow or green
How is the smell of the discharge associated with trichomoniasis described?
Can be offensive, but not always as in bacterial vaginosis
What is the consistency of the discharge associated with trichomoniasis?
Thin, homogenous
What happens to the pH of the vagina during trichomoniasis?
Increases to pH 4.5 - 7.0
How is the diagnosis of trichomoniasis confirmed?
Microscopy of vaginal secretions mixed with saline and culture
What medium should be used to culture trichomona vaginalis?
Fineberg-Whittington
What is seen on microscopy of vaginal secretions of someone with trichomoniasis?
Numerous polymorphonuclear cells with moving flagellae
How do we manage a patient with trichomoniasis?
Metronidazole 2g stat
OR
Metronidazole 400 mg BD for 5 days
OR
Tinidazole 2g stat
Partner notification is needed
What are the complications of trichomoniasis?
PID
Risk factor for preterm birth
How would you treat recurrent trichomoniasis?
Higher doses of metronidazole - 400mg TDS and then 1g PR or IV if still recurring
Arsphenamine pessaries and clotrimazole can be used
What are the side effects and contraindications of fluconazole?
Deranged LFTs at high doses
Avoid in pregnancy
