Vaginal Trichomoniasis

Other Causes of Vaginal Discharge

Vaginal Trichomoniasis

Symptoms

  • thin, yellow/green, offensive discharge, may be offensive
  • vulvovaginal irritation or pain
  • dyspareunia
  • external dysuria
  • no increased frequency / urgency
  • May be lower abdo discomfort

Signs

  • reddening of vulva/vagina/cervical mucosa
  • 2% have strawberry cervix appearance on colposcopy

Up to half have urethral trichomoniasis – which may cause dysuria and frequency if trigone of bladder is involved. 

Investigation

  • Direct wet preparation for typical motile protozoa
  • swab in transport media / Geinberg’s liquid culture medium – examine for protozoa after 2 days incubation

Treatment

  • Metronidazole 400mg BD 5-7days (200mg TDS 7 days if pregnant)
  • or Metronidazole 2g for single dose (if compliance is a problem) – avoid this stat dose if pregnant or breast feeding
  • or tinidazole 2g as single dose
  • Patients need to abstein from alcohol in view of disulfiram-like reaction
  • Male partners should also be treated
  • During treatment condoms should be used
  • treat women even if assymptomatic if it’s found on swab