Vaginitis: Trichomonas

Chapter 96 Vaginitis: Trichomonas



INTRODUCTION



Description: Trichomonas vaginitis is a vaginal infection by an anaerobic flagellate protozoan, Trichomonas vaginalis.

Prevalence: Roughly 3 million cases per year, 25% of “vaginal infections.”

Predominant Age: 15 to 50 (may occur at any age)

Genetics: No genetic pattern.


ETIOLOGY AND PATHOGENESIS



Causes: Trichomonas vaginalis, an anaerobic flagellate protozoan.

Risk Factors: Multiple sexual partners, vaginal pH that is less acid (blood, semen, or bacterial pathogens increase the risk).


CLINICAL CHARACTERISTICS



Signs and Symptoms (40% may be asymptomatic)



• Vulvar itching or burning

• Copious discharge with a rancid odor (generally thin, runny, and yellow–green to gray in color, “frothy” in 25%)

• “Strawberry” punctation of the cervix and upper vagina (15%, pathognomonic when present)

• Dysuria

• Dyspareunia

• Edema or erythema of the vulva


DIAGNOSTIC APPROACH



Differential Diagnosis



• Bacterial vaginitis

• Bacterial vaginosis

• Chlamydial cervicitis

• Gonococcal cervicitis


Associated Conditions: Other sexually transmitted infections (specifically gonorrhea and chlamydia).


Workup and Evaluation



Laboratory: Culture or monoclonal antibody testing may be obtained but is seldom necessary. Evaluation for concomitant sexually transmitted infections should be strongly considered. U.S. Food and Drug Administration–cleared tests for trichomoniasis in women include OSOM Trichomonas Rapid Test (Genzyme Diagnostics, Cambridge, Massachusetts), an immunochromatographic capillary flow dipstick technology, and a nucleic acid probe test that evaluates for T. vaginalis, Gardnerella vaginalis, and C. albicans

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Jun 6, 2016 | Posted by in GYNECOLOGY | Comments Off on Vaginitis: Trichomonas

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