Trichomonas Vaginalis

Overview/prevalence

Trichomoniasis is a genitourinary infection.  It is one of the most prevalent non-viral sexually transmitted infections.  This affects females more than males. It is one of the 3 most common diagnoses due to infections for vaginal complaints in women of reproductive age. 

Cause

It is due to the protozoan Trichomonas vaginalis

Symptoms

Early symptoms of Trichomoniasis include foul-smelling, thin vaginal discharge. This may include burning, itching, pain with urination, increased frequency urinating, lower abdominal pain, and/or pain with sexual intercourse.

Chronic infections have less intense symptoms and may include itching and pain with sexual intercourse, with scanty vaginal discharge.

On physical examination there may be redness in the vaginal area 

Trichomoniasis in men can present with urethral discharge and pain and burning with urination. 

There may also be associated itching and burning after sexual intercourse. In men this may lead to epididymitis, infertility and possibly prostate cancer. 

Newborns can contract this during delivery and may present with fever, urinary tract infection, nasal discharge and respiratory issues.  

Diagnosis

The preferred method of diagnosis can be made on a wet mount with direct observation of the motile organisms or with a nucleic acid amplification test.

Treatment

Treatment is aimed at both symptomatic and asymptomatic individuals. The 5-nitroimidazole drugs are the class of medications used to treat Trichomoniasis.

Partners of those with Trichomoniasis should also be treated. Sexual intercourse should not resume until both the affected and the partner have completed treatment and they have no symptoms. 

All women with a documented positive trichomonas test should have a repeat nucleic acid amplification test 3 weeks to 3 months after treatment.

Complications

Untreated infections may lead to abscesses, urethritis, pelvic inflammatory disease, infertility, increased risk of having HIV, and other sexually transmitted infections. There is also an indirect link between Trichomoniasis and cervical cancers. 

In patients that are pregnant they are at an increased risk of preterm labor.

Prevention

Using condoms and spermicides helps to decrease the transmission of Trichomoniasis.