TV

Question 1

What is TV?

Answer 1

Flagellated protozoan

Found in vagina urethra and paraurethral glands

90% women urethral infection coexists

Question 2

Symptoms in women?

Answer 2

None (up to 50%)
D/c
Itch
Dysuria
Rarely lower abdo pain/ulcers

Question 3

Signs women?

Answer 3

None
D/C 70%-varying
Only 2% strawberry cx

Question 4

Symptoms and signs men?

Answer 4

Usually urethral so

Up to 50% asymptomatic
Urethral d/c
Dysuria

Sometimes irritation and frequency

Sometimes d/c seen o/e often nothing seen

Question 5

TV complications?

Answer 5

Pregnancy-association (causality not established) preterm/low birth weight/postnatal sepsis

Treatment doesn’t positively impact pregnancy

HIV transmisdion greater

Question 6

How to diagnose? Who to test?

Answer 6

Women with d/c or vulvitus
VVS NAAT (microscopy wet slide post fornix less sesnsitve but immediate)

Men with persistent urethritis or contact FCU

Question 7

Management?

Answer 7

Avoid sex until partner and self treated (at least 1 week depending if stat dose or 7/7)

First line 500/400 metro bd 7/7
2g stat less effective

Question 8

PN?

Answer 8

4/52

Question 9

Pregnancy/BF?

Answer 9

No stat otherwise same (400 bd 7/7)

Question 10

Metro allergy?

Answer 10

Desensitise

Question 11

TOC?

Answer 11

Only if still sx…4/52

Ensure compliance/no reinfection

Question 12

Persistent infection?

Answer 12

First of all retreat same dose,
Then try increased doses eg 800 tds 7/7 metro