TRICHOMONAS

VAGINAL
INFECTION
BOHOLST.KATEBE.OLOD
 Trichomonas Vaginal InfecBon
EsBmated 5million new cases annually in the
United States
Most prevalent non-viral, non-chlamidial STI of
women
Highly contagious STI: 1 sexual act has at least 2
thirds of sexual partners become infected
associated with upper genital tract infecBons,
including infecBons aSer delivery, surgery,
aborBon, pelvic inammatory disease, preterm
delivery, inferBlity, and cervical dysplasia
treatment
 Trichomonas vaginalis
associated with upper genital tract infecBons,
including infecBons aSer delivery, surgery,
aborBon, pelvic inammatory disease,
preterm delivery, inferBlity, and cervical
dysplasia treatment
 Trichomoniasis: EBology
caused by the anaerobic women with posiBve
agellated protozoon T. culture = 30-40%male
vaginalis partners
normally fusiform in shape Men with posiBve culture =
Trichomonas vaginal 85% female partners
infecBonis the cause of incubaBon period 4-28 days
acute vaginiBs in 5% to 50%
of cases
 Trichomoniasis:
Survive upto 24 hours Growth favors:
on wet towel Menstrual ow
6 hours on moist Semen
surface Viral pathogen
growth resistant to
highly acidic vagina
 Trichomoniasis: Signs and Symptoms
profuse vaginal discharge which feels wet
Abnormal vaginal odor (50% of symptomaBc women)
Vulvar pruritus
Dysuria (1 out of 5)
Malodorous Discharge ( chronic infecBon)
PosiBve wet smears/cultures (3%-10% of asymptomaBc gyne
paBents)
 Trichomoniasis: Signs and Symptoms
Erythema and edema of vulva and vagina
Unpleasant odor of discharge
Classic Discharge:
Frothy (with bubbles)
Discharge color may be:
White
Gray
Yellow
Green
 Trichomoniasis: DiagnosBcs
Nucleic Acid AmplicaBon Test
3-5 Bmes more sensiBve than wet prep
Can be performed on vaginal secreBons or uine
Previously:
Culture considered gold standard
Wet prep most common performed diagnosBc test
Under best condiBons when samples are viewed
within 10 minutes of collecBon and the swab does not
dry out , wet prep is 80% sensiBve to idenBfy
Bchomonads
Papanicolou (PAP) Smear:
Error rate of at least 50%
 Trichomoniasis: Treatment
Nitroimidazoles
Only class of drugs recommended
Single oral dose (2g)of metronidazole or Bnidazoleis
recommended
Metronidazole 500mg orally, twice daily for 7 days
Alternate regimen
Not eecBve for HIV-infected women
 Trichomoniasis: Treatment
Tinidazole
Second-generaBon nitriomidazole
Half-life of 24 hours
Category C drug in pregnancy
Metronidazole
Safe in all trimesters of pregnancy
 Trichomoniasis: Treatment
Nitromidazoles
Inhibits ethanol metabolism
Nausea
Most frequent complicaBon
Experienced by 5%
 Trichomoniasis: Treatment
PaBents should be rescreened with a NAAT in 3
months due to high reinfecBon rates. In most cases,
women who have a recurrence have been re-
infected or complied poorly with therapy.
T. vaginalis is sexually transmijed, treatment of the
womans partner is important and increases cure
rates
Thank you