Trichomonas vaginalis is a highly motile, flagellated protozoan parasite. Trichomoniasis is a sexually transmitted infection (STI).

PC

*Up to 50% of women are aymptomatic

• vaginal discharge: offensive, yellow/green, frothy
• vulvovaginitis
• in men is usually asymptomatic but may cause urethritis

On examination:

• speculum examination: discharge, strawberry cervix

Investigations

• pH > 4.5 (normal 3.5 to 4.5)
• High vaginal swab from posterior fornix - gram staining and exclude other causes
• microscopy of a wet mount shows motile trophozoites

Management

• Suspected trichomoniasis - refer women to GUM clinic to confirm diagnosis
• oral metronidazole 400mg for 5-7 days, although the BNF also supports the use of a one-off dose of 2g metronidazole
• Offer patient information on the STI