From the Guidelines
Trichomonas vaginalis infection typically presents with a diffuse, malodorous, yellow-green discharge with vulvar irritation in women, while men are often asymptomatic but may develop nongonococcal urethritis. The clinical presentations of Trichomonas vaginalis infection can vary between men and women. In women, the infection often causes a diffuse, malodorous, yellow-green discharge with vulvar irritation, as noted in studies 1. However, some women may have minimal or no symptoms. Men, on the other hand, are often asymptomatic carriers but may develop nongonococcal urethritis, as mentioned in 1 and 1. Key features of the infection include:
- A diffuse, malodorous, yellow-green discharge with vulvar irritation in women
- Asymptomatic carriage in men, with possible development of nongonococcal urethritis
- Diagnosis through microscopic examination of vaginal secretions, culture, or nucleic acid amplification tests, as discussed in 1
- Treatment with oral metronidazole, as recommended in 1 and 1, with the goal of relieving symptoms, achieving microbiologic cure, and reducing transmission. The recommended treatment regimen for Trichomonas vaginalis infection is oral metronidazole, which has resulted in cure rates of about 90 to 95 percent, as noted in 1.
From the Research
Clinical Presentations of Trichomonas vaginalis Infection
The clinical presentations of Trichomonas vaginalis infection are varied and can include:
- Vaginitis, characterized by a foamy yellowish odorous discharge and superficial defects and necrotic ulcers in vaginal mucosa 2
- Cervicitis, which can occur in women 3, 4
- Urethritis, which can occur in men 3
- Pelvic inflammatory disease (PID) 3
- Adverse birth outcomes, such as preterm birth and premature rupture of membranes (PROM) 5
- Asymptomatic disease, which is common in both men and women 3, 4
Symptoms and Diagnosis
Symptoms of Trichomonas vaginalis infection can include:
- Reproductive tract discharge and irritation 5
- Altered vaginal discharge in symptomatic women 6
- Vulvo-vaginitis 6 Diagnosis of Trichomonas vaginalis infection can be made using:
- Wet mount microscopy and direct visualization, although these methods are insensitive 3
- DNA amplification techniques, which perform with good sensitivity but are not yet approved for diagnostic purposes 3
- Nucleic acid amplification tests (NAATs) 4
- Immunoassay based Point of Care testing 4