Trichomoniasis

Introduction 

Trichomoniasis is a disease caused by the flagellated protozoan parasite Trichomonas vaginalis which manifests as vaginitis in women and nongonococcal urethritis in men 

-It is the most prevalent nonviral sexually transmitted disease worldwide

-it is most often transmitted during sexual contact 

-risk factors include prostitution, multiple sexual partners 

-Females are more often affected and symptomatic than males

Symptoms & Signs 

Women: Vulvovaginal discomfort, pruritis, dysuria, dyspareunia, copious vaginal discharge, no foul smelling, frothy, yellow or green colored discharge pooled in the posterior vaginal fornix, punctuate hemorrhages over vaginal walls, A red, granular, friable endocervix (Strawberry cervix); symptoms worsen during menses and pregnancy; increased risk of preterm birth 

Men: Most infected men are asymptomatic; dysuria, dyspareunia, and scant urethral discharge 

Diagnosis 

T. vaginalis can be recovered from the urethra of both males and females 

-it is detectable in males after prostatic massage

-Diagnostic methods: Wet-mount microscopy, culture, molecular tests (Nucleic acid amplification tests) 

-Trichomonas vaginalsis has characteristic twitching movements, it contains 4 frontal and 1 larger back flagella, which is embedded into an undulating membrane

Treatment

All infected persons should be treated, even if asymptomatic to prevent reinfection and to limit the spread 

Effective agents: Metronidazole, tinidazole 

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