Trichomoniasis Vaginalis ✅
Related Subjects:
|Trichomoniasis Vaginalis
|Gardnerella vaginalis
|Chlamydia trachomatis
🔬 About
- 🦠 Trichomoniasis is caused by the protozoan parasite Trichomonas vaginalis.
- ❤️🔥 It is a sexually transmitted infection (STI) affecting the urogenital tract.
- 👩 In women, infection usually involves the vagina and often the urethra; 👨 in men, it usually affects the urethra.
- 😶 Many infections are asymptomatic, especially in men, so transmission may occur unknowingly.
- 📈 Concurrent STIs are common, so full STI screening is recommended.
🧬 Aetiology / Transmission
- 🤝 In adults, transmission is almost exclusively through sexual intercourse.
- ⚠️ Risk factors include multiple sexual partners, previous STIs, and lack of barrier protection.
- 💧 Fomite transmission is not a usual route and should not be emphasised.
🩺 Clinical Features
- 👨 In men:
- 😶 Often asymptomatic.
- 🔥 Dysuria or urethral irritation.
- 💧 Urethral discharge.
- 👩 In women:
- 🔥 Vulval irritation, soreness, or itching.
- 🚽 Dysuria.
- 💨 Vaginal discharge, which may be offensive; classical frothy yellow discharge occurs but is not always present.
- ❤️🩹 Dyspareunia may occur.
🔎 Investigations
- 🧬 NAAT is the preferred diagnostic test.
- 🔬 Wet mount microscopy may identify motile trichomonads but is less sensitive.
- 🩸 Offer full STI screening (for example HIV, gonorrhoea, chlamydia, syphilis as appropriate).
- 🏥 Referral to a sexual health / GUM clinic is strongly recommended for diagnosis confirmation, partner notification, and management.
💊 Management
- ✅ First-line: Metronidazole 400 mg twice daily for 7 days.
- 📌 Alternative: Metronidazole 2 g single dose if adherence is a concern.
- 🤰 In pregnancy or breastfeeding, avoid the 2 g single-dose regimen; seek specialist sexual health advice.
- 👩❤️👨 Treat the current sexual partner(s) and any partner(s) from the previous 4 weeks.
- 🚫 Avoid sex for at least 1 week and until the person and partner(s) have completed treatment.
- 🍷 Avoid alcohol with metronidazole.
- ❌ Clotrimazole may help vaginal symptoms but is not curative.
⚠️ Complications
- 🧩 Increased risk of transmission or acquisition of other STIs.
- 🤰 Associated with adverse pregnancy outcomes including preterm delivery and low birth weight.
- 🔁 Persistent symptoms may reflect reinfection, poor adherence, resistance, or an alternative diagnosis.
🛡️ Prevention
- 🧷 Condom use reduces risk.
- 📢 Partner notification and treatment are essential.
- 🔁 Consider repeat assessment if symptoms persist or recur.
📚 References
