vaginal discharge trichomoniasis

1. VAGINAL DISCHARGE
TRICHOMONAS VAGINALIS

2. INTRODUCTION:
• Most common parasitic cause of STD
• Females are commonly affected than males
• Increase risk of HIV infection

3. MORPHOLOGY:
• Pear shaped
• Jerky or twitching motility on saline mount
• Bears 5 flagella
4 anterior flagella
1 lateral flagellum attached to undulating membrane

4. • Resides in :
Females – Vagina and urethra
Male- Urethra, seminal vesicle and prostate

5. CLINICAL FEATURE:
• 25-50% infections are asymptomatic
• Discharge- Profuse
Foul smelling
Greenish Yellow Frothy Discharge
• On colposcopy- small punctate hemorrhagic spots on
vagina and cervix (colpitis macularis)
seen in 2% cases only

6. GREEN YELLOW FROTHY DISCHARGE COLPOSCOPY

7. • In chronic infection
Vaginal discharge is scanty
Dysparenia present
• Complications
Pyosalpinx
Endometritis
Infertility
Preterm labour

8. • Trichomonas vaginalis can also cause non
gonococcal urethritis in womens
• In males: common features are non gonococcal urethritis
Other rare features are epididymitis, prostitis
and penile ulcers

9. DIAGNOSIS:
• DIRECT MICROSCOPY:
1. WET MOUNT: jerky motile trophozoites are visible
2. PERMANENT STAIN : geimsa and papanicolaou stain
• CULTURE:
1. Gold standard
2. High specificity and sensitivity
3. Commonly used culture media – diamond trypticase
yeast maltose media

10. • Antigen detection in vaginal secretion-
1. Rapid ICT
2. ELISA
• Antibody detection
• Moleculer method
• OTHER SUPPORTIVE TESTS:
1. Raised vaginal ph (>4.5)
2. Positive whiff test

11. TREATMENT (CDC)
• Recommended Regimen
• Metronidazole 2 g orally in a single dose
OR
• Tinidazole 2 g orally in a single dose

12. TREATMENT(NACO)