The Wayback Machine - https://web.archive.org/web/20160320104027/http://fpnotebook.com:80/Gyn/ID/TrchmnlVgnts.htm
Logo

Trichomonal Vaginitis

Aka: Trichomonal Vaginitis, Trichomonas, Trichomoniasis

I. See also

  1. Vaginitis

II. Epidemiology

  1. Accounts for 10% of Vaginitis
  2. Prevalence
    1. General gynecology clinics: 13-23%
    2. Prostitutes: 75%
    3. Increasing Prevalence in asymptomatic women over age 45 years old
  3. Transmission
    1. Sexually Transmitted Disease
    2. Men are asymptomatic in 90% of cases
    3. Often transmitted with Gonorrhea and Chlamydia
    4. Rarely transmitted by moist cloths

III. Etiology

  1. Protozoan infection

IV. Symptoms

  1. Asymptomatic in 25-44% of women
  2. Copious, yellow-green or grayish-green Vaginal Discharge (variably present)
    1. Fishy odor to discharge (variably present)
    2. Frothy discharge (Carbon dioxide bubbles)
      1. Sensitivity: 10%
      2. Specificity: 70%
  3. Vulvar and vaginal Pruritus with irritation and edema
  4. Dysuria (20%)

V. Signs

  1. Vulvar edema and erythema
  2. Tender vaginal or vulvar ulcerations
  3. Strawberry Cervix (2-3% of cases)
    1. Punctate Hemorrhages or Petechiae
    2. Telangiectasia

VI. Lab

  1. Vaginal pH > 5.0
  2. KOH Preparation
    1. Sniff Test positive
      1. Fishy odor to discharge when KOH added (often negative)
  3. Wet preparation (from vaginal vault, not endocervix)
    1. Read slide immediately
      1. Motility wanes quickly, over minutes
      2. Trichomonad shape morphs from pear-shaped to round with slide drying
    2. Motile pear shaped Trichomonads with flagella exiting from tapering end (70%)
      1. Twice the size of White Blood Cells (WBC)
      2. GynVaginitisTrichomonas.jpg
    3. Efficacy
      1. Test Sensitivity: 60-70%
  4. Specific diagnostic tests (available as point-of-care clinic based tests)
    1. Osom Trichomonas Rapid Test
    2. BD Affirm VPIII Microbial Identification Test
    3. Efficacy
      1. Test Sensitivity: 83%
      2. Test Specificity: >97% (false positives are a concern in regions of low Prevalence)
  5. Other testing
    1. Gram Stain
      1. White Blood Cells over 10 per high powered field
    2. Culture of Trichomonas vaginalis
      1. Grown on modified Diamond media

VII. Associated Conditions

  1. Preterm Labor
  2. Test for other Sexually Transmitted Disease
    1. NeisseriaGonorrhea
    2. Chlamydia trachomatis

VIII. Management

  1. General
    1. Treat Sexual Partner also
      1. Metronidazole 500 mg orally twice daily for 7 days is most effective for male partners
    2. Avoid treatment in first trimester of pregnancy
    3. Avoid intravaginal preparations of Metronidazole or Tinidazole due to low cure rates
  2. Non-Pregnant, Non-Lactating Patient
    1. Metronidazole (Flagyl) 2 g orally for 1 dose (preferred) or
    2. Metronidazole (Flagyl) 250 mg PO three times daily for 7 days or
    3. Metronidazole (Flagyl) 500 mg PO twice daily for 7 days or
    4. Tinidazole (Tindamax) 2 grams orally for 1 dose
      1. Teratogenic, Category D (do not use if any risk of pregnancy)
  3. Pregnant (after first trimester, and preferred after 37 weeks)
    1. Metronidazole (Flagyl) 2 g PO for 1 dose ($5) or
    2. Metronidazole (Flagyl) 500 mg PO bid for 7 days
  4. Lactation
    1. Metronidazole (Flagyl) 2 grams PO for 1 dose
    2. Discontinue Lactation for 24 hours after dose
  5. Persistent or Recurrent Cases
    1. Retreat both the partner and the patient
    2. Metronidazole 500 mg PO bid for 14 days
    3. Metronidazole 2g PO qd for 3 days
    4. Metronidazole gel 5g PV bid for 5 days ($30)
    5. Povidone-Iodine Suppository PV bid for 14 days ($60)
    6. Clotrimazole 100 mg vag tab PV qhs for 7 days ($14)
    7. Tinidazole 2 g orally daily for 5 days
      1. Teratogenic, Category D (do not use if any risk of pregnancy)
    8. Paromomycin (Humatin) 5g intravaginally qd x14 days
      1. Higher rate of Vulvitis and local ulceration

IX. References

  1. Mandell (2000) Infectious Disease, Churchill, p. 2894-7
  2. (1998) MMWR Morb Mortal Wkly Rep 47:1-115 [PubMed]
  3. Epling (2001) Am Fam Physician 64(7):1241-4 [PubMed]
  4. Workowski (2006) MMWR Recomm Rep 55:1-94 [PubMed]

Images: Related links to external sites (from Bing)

These images are a random sampling from a Bing search on the term "Trichomonal Vaginitis." Click on the image (or right click) to open the source website in a new browser window. Search Bing for all related images

Related Studies (from Trip Database) Open in New Window

Ontology: Trichomonas Infections (C0040921)

Definition (MEDLINEPLUS)

Trichomoniasis is a sexually transmitted disease caused by a parasite. You get it through sexual intercourse with an infected partner. Many people do not have any symptoms. If you do get symptoms, they usually happen within 5 to 28 days after being infected.

Symptoms in women include

  • Yellow-green or gray discharge from the vagina
  • Discomfort during sex
  • Vaginal odor
  • Painful urination
  • Itching in or near the vagina

Most men do not have symptoms. If they do, they may have a whitish discharge from the penis and painful or difficult urination and ejaculation.

Lab tests can tell if you have the infection. Treatment is with antibiotics. If you are infected, you and your partner must be treated. Correct usage of latex condoms greatly reduces, but does not eliminate, the risk of catching or spreading trichomoniasis.

NIH: National Institute of Allergy and Infectious Diseases
Definition (MSHCZE) Infek�ní onemocnění způsobené prvokem Trichomonas vaginalis (bi�íkovec poševní). Přenáší se zejm. pohlavním stykem a způsobuje u ženy zánět s výtokem. U mužů probíhá bu� bez příznaků, nebo jako zánět mo�ové trubice. Lé�í se některými chemoterapeutiky (např. metronidazolem), nutná je lé�ba sexuálních partnerů. (cit. Velký lékařský slovník online, 2013 http://lekarske.slovniky.cz/ )
Definition (MSH) Infections in birds and mammals produced by various species of Trichomonas.
Concepts Disease or Syndrome (T047)
MSH D014245
ICD9 131.9, 131
ICD10 A59 , A59.9
SnomedCT 187206001, 187364002, 56335008, 105648001
English Infections, Trichomonas, Infection, Trichomonas, Trichomonas NOS, Trichomoniasis, unspecified, [X]Trichomoniasis, unspecified, INFECT TRICHOMONAS, TRICHOMONAS INFECT, Trichomonas Infections, trichomoniasis (diagnosis), trichomoniasis, Trichomonas infections, Trichomoniasis NOS, Trichomonas Infections [Disease/Finding], trichomonosis, trichomona, trichomonas infection, trichomonas, Trichomonas NOS (disorder), [X]Trichomoniasis, unspecified (disorder), Trich, Trichomoniasis, Trichomonosis, Disease due to Trichomonadidae (disorder), Disease due to Trichomonadidae, Infection by Trichomonas (disorder), Infection by Trichomonas, Trichomonas; infection, infection; Trichomonas, Infection by Trichomonas, NOS, Trichomonas Infection
Italian Infezioni da trichomonas, Tricomoniasi, Tricomoniasi NAS, Infezioni da Trichomonas
Dutch trichomoniasis, niet-gespecificeerd, Trichomonas; infectie, infectie; Trichomonas, Trichomoniasis, niet gespecificeerd, Trichomonasinfecties, trichomoniasis, Trichomoniasis
French Trichomonase, non précisée, Infections à Trichomonas, Trichomonase, Trichomoniase
German Trichomoniasis, unspezifisch, Trichomoniasis, nicht naeher bezeichnet, Trichomonen-Infektionen, Trichomonadeninfektionen, Trichomoniasis
Portuguese Tricomoníase NE, Infecções por Tricomonas, Infecções a tricomonas, Tricomoníase
Spanish Tricomoniasis no especificada, [X]tricomoniasis, no especificada, Trichomonas, SAI, [X]tricomoniasis, no especificada (trastorno), Trichomonas, SAI (trastorno), Infecciones por Tricomonas, enfermedad por Trichomonadidae (trastorno), enfermedad por Trichomonadidae, infección por Trichomonas (trastorno), infección por Trichomonas, tricomoniasis, tricomonosis, Infecciones por tricomonas, Tricomoniasis
Japanese トリコモナス感染, トリコモナス症�詳細�明, ﾄﾘｺﾓﾅｽｶ�ｾ�, ﾄﾘｺﾓﾅｽｼｮｳ, ﾄﾘｺﾓﾅｽｼｮｳｼｮｳｻｲﾌﾒｲ, トリコモナス感染症, トリコモナス症
Swedish Trichomonasinfektioner
Finnish Trikomoniaasit
Russian TRIKHOMONADNYE INFEKTSII, ТРИХОМО��Д�ЫЕ И�ФЕКЦИИ
Czech Trichomonádové infekce, Trichomoniáza, Trichomoniáza, blíže neur�ená, Trichomonas - infekce, trichomoniáza, trichomonóza
Korean 편모충�, �세불명� 편모충�
Polish Trichomoniaza, Rzęsistkowica, Trychomonadoza
Hungarian Trichomonas fertőzések, trichomoniasis, trichomoniasis, nem meghatározott
Croatian Trihomonas, infekcije
Norwegian Trichomonasinfeksjoner, Trikomonasinfeksjoner
Derived from the NIH UMLS (Unified Medical Language System)

Ontology: Trichomonas Vaginitis (C0040923)

Definition (NCI) A sexually transmitted parasitic infection caused by Trichomonas vaginalis. Symptoms include vaginal discharge, vaginal odor, vaginal itching, and discomfort during intercourse.
Definition (MSH) Inflammation of the vagina, marked by a purulent discharge. This disease is caused by the protozoan TRICHOMONAS VAGINALIS.
Concepts Disease or Syndrome (T047)
MSH D014247
SnomedCT 187202004, 266165009, 187201006, 500000, 276877003
English Trichomonas Vaginitides, Vaginitides, Trichomonas, Vaginitis, Trichomonas, Trichomonal vulvovaginitis, Leukorrhea - vag.-trichomonal, Leukorrhea vaginalis - trichomonal, Leukorrhoea vaginalis - trichomonal, Trichomonal leukorrhea, Trichomonal leukorrhoea, trichomonas vaginalis vaginitis, Trichomonal vaginitis (diagnosis), Vaginitis trichomonal, Trichomonas Vaginitis [Disease/Finding], Trichomonas Vaginitis, trichomoniasis vaginal, vaginitis trichomonas, Vaginitis;trichomonal, trichomonas vaginitis, vaginal trichomoniasis, Trichomonal fluor vaginalis, Trichomonal leukorrhea vaginalis, Trichomonal vaginitis, Vaginal trichomoniasis, Trichomonal leukorrhoea vaginalis, Trichomonal vaginitis (disorder), Vaginal trichomoniasis (disorder), trichomonal vaginitis
French Vaginite trichomonale, Vaginite à Trichomonas
German Vaginitis durch Trichomonen, Trichomonaden-Vaginitis, Trichomonadenvaginitis, Trichomonas-Vaginitis, Trichomonas-Kolpitis, Trichomonadenkolpitis, Trichomonaden-Kolpitis, Vaginitis, Trichomonas-
Italian Vaginite da trichomonas, Vaginite da Trichomonas
Portuguese Vaginite a tricomonas, Vaginite por Trichomonas
Spanish Vaginitis por tricomonas, Tricomoniasis Vaginal, leucorrea vaginal por tricomonas, tricomoniasis vaginal (trastorno), tricomoniasis vaginal, vaginitis por tricomonas, vaginitis tricomoniásica (trastorno), vaginitis tricomoniásica, Vaginitis por Trichomonas
Japanese トリコモナス性腟炎, ﾄﾘｺﾓﾅｽｾｲ�ﾂｴ�
Swedish Trichomonas-vaginit
Czech trichomonádová vaginitida, Trichomonádová vaginitida, vaginální trichomonóza
Finnish Trikomonasvaginiitti
Russian TRIKHOMONADNYI VAGINIT, ТРИХОМО��Д�ЫЙ В�ГИ�ИТ
Polish Rzęsistkowica pochwy
Hungarian Vaginitis, trichomonas okozta, Trichomonas vaginitis
Norwegian Trichomonas-vaginitt, Trikomonas-vaginitt
Dutch Trichomonas-vaginitis, Vaginitis, trichomonas-
Derived from the NIH UMLS (Unified Medical Language System)

Related Topics in Infectious Disease

2016 Family Practice Notebook, LLC. Terms | Privacy (UBM) | About | Site Map | Blog

Footer Site Logo
Morty Proxy This is a proxified and sanitized view of the page, visit original site.