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SOURCE

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Source: Knodel LC, Duhon B, Argamany J. Sexually transmitted diseases. In: DiPiro JT, Talbert RL, Yee GC, Matzke GR, Wells BG, Posey LM, eds. Pharmacotherapy: A Pathophysiologic Approach. 10th ed. New York, NY: McGraw-Hill; 2017. http://accesspharmacy.mhmedical.com/content.aspx?bookid=1861&sectionid=146072585. Accessed March 9, 2017.

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DEFINITION

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  • Infection of genital and urinary tract.

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ETIOLOGY

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  • Caused by Trichomonas vaginalis, flagellated, motile protozoan.

    • Mostly transmitted by sexual contact.

    • Infection by nonsexual contact possible because T. vaginalis survives up to 45 min on moist surfaces.

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PATHOPHYSIOLOGY

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  • Trichomonads isolated from vagina, urethra, and paraurethral ducts and glands in women.

  • After attachment to the vaginal or urethral mucosa, there is usually an inflammatory response that manifests as a discharge containing large numbers of PMN leukocytes.

  • Infection in extragenital sites may be source for reinfection.

    • Reinfection more common when local therapy used alone.

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EPIDEMIOLOGY

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  • Coinfection with other sexually transmitted infections (STIs), eg, gonorrhea, is common.

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PREVENTION

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  • Mutually monogamous sexual relationship between uninfected partners.

  • Barrier contraceptive methods.

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RISK FACTORS

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  • Unprotected sex.

  • Number of sexual partners.

  • Sexual preference.

  • Age: Half of STIs occur in persons in teens and twenties.

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CLINICAL PRESENTATION

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  • More common in women than in men.

  • Typical presentation of trichomoniasis in men and women in Table 1.

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Table Graphic Jump Location
TABLE 1.Presentation of Trichomonas Infections
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SIGNS AND SYMPTOMS
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DIAGNOSIS

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MEANS OF CONFIRMATION AND DIAGNOSIS
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  • Simplest and most reliable means of diagnosis: wet-mount examination of vaginal discharge.

    • Trichomoniasis confirmed if characteristic is pear ...

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