October 7, 2022
Gynae/Obstr

Trichomoniasis : most common STD in female

  • April 10, 2011
  • 3 min read
  • 9 Views
Trichomoniasis : most common STD in female

Trichomomal Vaginitis is the most common vaginitis in the childbearing period.

Causative Organism and Transmission-

It is caused by a protozoan called Trichomonas vaginalis which is 20 micrometer X 10 micrometer pear shaped parasitic organism. It has 4 anterior flagellae and a spear-like protrusion at the other end . It is covered by an undulating membrane on its anterior 2/3rd. It is actively motile organism. If you’re distressed, fortunately, those free testing options isn’t that rare in the local std testing centers near you.

Predominantly transmitted by sexual contact. Urethra and prostrate of Male ( men) harbors the trichomonas and may even be transmitted via toilet articles from women-women or via examining gloves of a health personnel.

Incubation period is 3-28 days.

Pathology-

25% of women in reproductive age group have asymptomatic infection. When local defence mechanisms are impaired during menstruation, following illness or having sex after having a baby, the pH of vagina is raised to 5.5-6.5. Trichomonas infectio

n can thus occur at this pH. They produce inflammatory

reaction.

75% organism can be isolated from Urethra, Skene’s tubules and Bartholin’s gland .

Clinical Features-

  1. There is profuse, offensive vaginal discharge ( usually following menstruation)
  2. Itching and Irritation mild to severe around the genitalia
  3. Urinary symptoms like dysurea ( painful urination), frequency of urination can occur
  4. History of similar attacks in past may be derieved
  5. Up to one-third of infected women have no symptoms

Men

  • The majority of infected men have no symptoms
  • Urethral discharge,Pain with urination – dysurea
  • Pain and swelling in the scrotum

On Examination-

  • Thin, froathy, greenish to yellow, offensive discharge per vaginum
  • The vulva is inflamed, Evidence of pruritis like scratch marks, abrasions, redness may be seen.
  • Per vaginal examination may be painful, red inflamed walls with punctuate hemorrhages can be seen. Similar lesions may also be seen  over the PortioVaginalis part of Cervix and may be “ Strawberry” appearance.

Diagnosis-

  • Identification is done by Hanging drop preparation. Motile organisms may be found. If negative on repeated examinations, culure should be done for confirmation.
  • Culture of the discharge collected by swabs in Kupfberg’s or Fein Whittington medium.

D/D– Gonorrhea, Candidiasis.

Treatment-

  1. Metronidazole is quiet effective for the treatment. 200mg TDS PO for 1 week is given. Partner should be treated at the same time and for same duration. Barrier methods of contraception should be used until cured. A second course of therapy may be required if the symptoms persist after 7 days. Upto 3 cycles in 3 months may be needed.Use of Metronidazole in Pregnancy  can cause teratogenic effects on fetus ( congenital malformations).
  2. Clotrimazole pessaries 100mg for consecutive 6 nights. It is preferred during pregnancy and lactation. It treats candidiasis as well.

More Readings at- Simplified Trichomoniasis ,Patients’s Reading

Leave a Reply

Your email address will not be published.

This site uses Akismet to reduce spam. Learn how your comment data is processed.