Trichomonas vaginalis is a type of parasite spread through sexual intercourse

Aetiology

• Trichomonas is spread through sexual activity and lives in the urethra of men and women and the vagina of women

Clinical features

Symptoms

• Up to 50% of cases of trichomoniasis are asymptomatic
• When symptoms occur, they are non-specific:
  • Vaginal discharge - typical description of the vaginal discharge is frothy and yellow-green, may have a fishy smell
  • Itching
  • Dysuria (painful urination)
  • Dyspareunia (painful sex)
  • Balanitis (inflammation to the glans penis)

Signs

• Examination of the cervix can reveal a characteristic ‘strawberry cervix’

Investigations

• Standard charcoal swab with microscopy
  • Swabs should be taken from the posterior fornix of the vagina  (behind the cervix) in women; a self-taken low vaginal swab  may be used as an alternative
  • A urethral swab or first-catch urine is used in men

Management

• Metronidazole - either 400-500mg twice a day for 5-7 days, or a single dose of 2g orally