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SOURCE

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.

DEFINITION

  • Infection of genital and urinary tract.

ETIOLOGY

  • 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.

PATHOPHYSIOLOGY

  • 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.

EPIDEMIOLOGY

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

PREVENTION

  • Mutually monogamous sexual relationship between uninfected partners.

  • Barrier contraceptive methods.

RISK FACTORS

  • Unprotected sex.

  • Number of sexual partners.

  • Sexual preference.

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

CLINICAL PRESENTATION

  • More common in women than in men.

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

TABLE 1.Presentation of Trichomonas Infections

SIGNS AND SYMPTOMS

DIAGNOSIS

MEANS OF CONFIRMATION AND DIAGNOSIS

  • Simplest and most reliable means of diagnosis: wet-mount examination of vaginal discharge.

    • Trichomoniasis confirmed if characteristic is pear ...

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