Trichomonas vaginalis
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Summary
Trichomonas vaginalis, also shortened as Trichomonas or simply “trick”, is a flagellated parasite that is sexually transmitted. A Trichomonas infection is formally called trichomoniasis, and includes vaginitis, characterized by a yellow-green colored vaginal discharge. Trichomoniasis can also present with cervicitis with the appearance of a “strawberry cervix” on speculum exam.
Trichomonas can be diagnosed by wet mount microscopy, in which the vaginal discharge discussed earlier is prepared on a slide, revealing motile trichomonads or swimming flagellated parasites.
The first line treatment for trichomonas is metronidazole.
Key Points
- Trichomonas vaginalis
- Characteristics
- Flagellated protozoan parasite
- Transmission
- Sexually transmitted
- Coinfection with other STIs is common
- Look for history of multiple sexual partners without protection
- Sexually transmitted
- Presentation: Trichomoniasis
- Vaginitis
- Parasite infects squamous epithelium in vaginal mucosa
- Yellow-green vaginal discharge
- May be foul-smelling
- Contrast vs. Gardnerella, which causes grey-white discharge
- Itching, burning, and other discomfort may be seen
- Vaginal pH may be elevated
- Urethritis may be seen in men
- Vaginitis
- Diagnosis
- Motile trichomonads on wet mount (saline) microscopy
- Flagellated pear-shaped or round organisms with jerky and spinning movements are seen
- PCR/NAAT
- Used when microscopy is inconclusive but trichomonas is still suspected
- Strawberry cervix
- Bright red inflamed cervix seen on speculum exam
- Motile trichomonads on wet mount (saline) microscopy
- Treatment
- Metronidazole for patient and partner
- Tinidazole may also be used
- Causes less GI side effects, but more expensive
- Tinidazole may also be used
- Metronidazole for patient and partner
- Characteristics