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Trichomoniasis...

Trichomoniasis...

Sexually transmitted disease!

Trichomoniasis is a sexually transmitted disease of the vagina or urethra caused by Trichomonas vaginalis, a unicellular microorganism with a tail similar to a whip.

Although Trichomonas vaginalis can infect the genitourinary tract of men or women, symptoms are more common in women.

Approximately 20% of women have vaginal trichomoniasis during their fertile years.

In men, the micro-organism infects the urethra, prostate, and bladder, but only rarely causes symptoms.

In some populations, Trichomonas may account for 5 to 10% of all cases of non-gonococcal urethritis.

The microorganism is more difficult to detect in men than in women.

The symptoms

In women, the disease usually begins with a foamy vaginal discharge yellow-green.
In some women, the discharge may be small.

The vulva (female external genital organ) can become inflamed and injured and intercourse can be painful.
In severe cases, the vulva and surrounding skin may become inflamed and the vaginal lips may become swollen.

The patient may experience pain upon urination and increased frequency of urination, remembering the symptoms of a bladder infection.
Generally, men with trichomoniasis are asymptomatic but can infect their sexual partners.

Some men have a temporary foamy or pus-like urethral discharge, pain on urination, and frequent urination.
These symptoms usually occur early in the morning.
The urethra may be slightly irritated and sometimes a moisture appears in the penile orifice.

In rare cases, infection of the epididymis occurs, causing pain in the testicles.

The prostate can also be infected, but the role of Trichomonas is not clear.

These infections are the only known complications of trichomoniasis in men.

Complications of Chlamydia and Ureaplasma Infections

ComplicationEffect Possible
In men
Infection of the epididymisPain in the testicle
Urethral stenosisUrinary flow obstruction
In women
Infection of the uterine tubesPain, ectopic pregnancy and infertility
Infection of the lining of the liver and of the area surrounding the liverUpper abdominal pain
In men and women
Conjunctivitis (eye white infection)Pain and ocular secretion
In neonates
ConjunctivitisPain and ocular secretion
PneumoniaFever and cough

Diagnosis of Trichomoniasis

In women, diagnosis can usually be established in a few minutes by microscopic examination of a sample of vaginal secretion.
In addition, tests are commonly performed for other other sexually transmitted diseases.

In men, secretions of the tip of the penis should be obtained in the morning, before the individual urinates.

The secretions are examined under a microscope and a sample is sent to the laboratory for culture.
A culture of urine may also be useful as this test is more likely to detect Trichomonas not seen on microscopic examination.

Treatment

A single oral dose of metronidazole cures up to 95% of infected women as long as their sexual partners are treated simultaneously.

As it is not known whether single dose treatment is effective for men, they are commonly treated for 7 days.
When ingested with alcohol, metronidazole may cause nausea and skin flushing.

Metronidazole may also cause decreased white blood cell count and, in women, increased susceptibility to vaginal fungal infections (genital candidiasis).

It may be best to avoid using metronidazole during pregnancy for at least the first three months.
Infected individuals who have sex before the infection is cured can infect their partners.

Video Editorial: What is Trichomoniasis? (Sexually Transmitted Infection)


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