Overview
Trichomonas vaginalis is a flagellated protozoan sexually transmitted infection that can cause purulent vaginal discharge in women and urethral infection in men.
Risk Factors
Risk factors include high-risk sexual activity:
- Unprotected anal or vaginal sex
- Multiple sexual partners
- High-risk sexual practices (e.g. chemsex)
- Other sexually transmitted infections (STIs) including syphilis, Chlamydia, gonorrhoea, and herpes
- Sex work
Presentation
Overview
Features of trichomoniasis include:
- In women:
- Abnormal vaginal discharge – often offensive (sometimes ‘fishy’ smelling), yellow/green, and frothy, symptoms may be worse during periods
- ‘Strawberry cervix’ – erythematous, punctuate haemorrhages on the cervix
- Men tend to be asymptomatic but can have urethritis
Investigations
Overview
Some tests and their findings include:
- Vaginal pH measurement: >4.5
- Wet mount microscopy – identifies motile trophozoites
Management
Overview
Treatment involves oral metronidazole for 5-7 days, however, a single 2g dose may be considered.
