Trichomonas Vaginalis

What is trichomoniasis?

Trichomoniasis is a sexually transmitted infection caused by the protozoan Trichomonas vaginalis. It is the most common non-viral STI worldwide with over 150 million new cases annually.

Symptoms

• Yellow-green frothy discharge — copious, foul-smelling
• Vaginal itching and irritation — intense vulvar itching
• Burning during urination — dysuria
• Pain during sex — dyspareunia
• "Strawberry cervix" — characteristic punctate hemorrhages (colposcopic finding)

Complications

• Increased HIV risk — trichomoniasis increases HIV transmission 2-3 fold
• In pregnancy — preterm birth, low birth weight, premature membrane rupture
• Co-infections — often associated with bacterial vaginosis and other STIs

Diagnostics

• Wet mount microscopy — motile trichomonads (sensitivity ~60-70%)
• PCR/NAAT — most sensitive method (>95%)
• Rapid antigen test — results in 10-15 minutes
• Culture — Diamond medium, high specificity

Treatment

Trichomoniasis is treated with metronidazole (single 2g dose or 500mg twice daily for 7 days). Both partners must be treated. Avoid alcohol during and 48 hours after therapy.