General

Question 1

Etiology of Trichomonas Vaginalis

Answer 1

Flagellated protozoon.
In women the organism is found in the vagina, urethra
and paraurethral glands. Urethral infection is present in
90% of infected women, although the urethra is the sole
site of infection in less than 5% of cases. In men infection
is usually of the urethra

Question 2

Symptoms of Trichomonas Vaginalis

Answer 2

. 10–50% are asymptomatic.
. The commonest symptoms include vaginal discharge,
vulval itching, dysuria, or offensive odour, but these are not specific for TV.
. Occasionally the presenting complaint is of low
abdominal discomfort or vulval ulceration.

Question 3

Signs of Trichomonas Vaginalis

Answer 3

. Vaginal discharge in up to 70% – varying in consistency from thin and scanty to profuse and thick; theclassical frothy yellow discharge occurs in 10–30%
of women.
. Vulvitis and vaginitis are associated with
trichomoniasis.
. Approximately 2% of patients will have strawberry
cervix appearance to the naked eye. Higher rates are
seen on colposcopic examination.
. 5–15% of women will have no abnormalities on
examination.

Question 4

Complications of Trichomonas Vaginalis

Answer 4

• Detrimental outcome on pregnancy and associated
  with preterm delivery and low birth weight.
• It may predispose to maternal postpartum sepsis.

Question 5

Lab investigations

Answer 5

• Microscopy. Detection of motile trichomonads by light- field microscopy which is then mixed with a small drop of saline on a glass slide.. The wet preparation should be read within 10 min of collection, as the trichomonads will quickly loose motility and be more difficult to identify. It has the advantage that it can be performed near to the patient and in a clinic setting.
• Detection of TV by staining dead organisms with
  acridine orange can give a higher sensitivity than wet
  microscopy
• NAAT

Question 6

Treatment of trichomonas vaginalis

Answer 6

. Metronidazole 2 g orally in a single dose
or
. Metronidazole 400–500 mg twice daily for 5–7 days