This is a parasitic protozoan infection, the result of infection with the flagellated anaerobic trichomonas vaginalis.
- This is the most common protozoan infection in the developed world
It is a sexually transmitted infection although men are usually asymptomatic.
- Hard to assess due to the very high rate of asymptomatic cases. Some estimates as high as 50% of the sexually active population.
- In men – usually asymptomatic
- In Women –may include a fishy smelling discharge, that is usually thin, green-yellow, and frothy.
- Strawberry cervix – in 10% of cases. The cervix has the appearance of a strawberry, due to small petechial haemorrhages.
- To the fetus
- Pre-term delivery
- Low birthweight
- Increased mortality
- To the mother
- Increased susceptibility to HIV
- Triple swabs – one for chlamydia, one for gonorrhoea, and one for other infections
- Gonorrhoea is particularly important to exclude as it often co-exists
- Culture and microscopy – the protozoa and its flagella can be seen on microscopy and cultured in the lab for definitive diagnosis
- Vaginal pH – >4.5
- Metronidazole – PO 400mg/12h for 5 days, or 2g PO stat dose (one off dose)
- Encourage treatment of the partner
- In pregnancy, use the 5-day regimen