Trichomoniasis overview
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Maliha Shakil, M.D. [2]
Overview
Trichomoniasis is a common sexually transmitted disease that affects 7.4 million previously unaffected Americans each year. It is caused by a single-celled protozoan parasite Trichomonas vaginalis. Trichomonas vaginalis was first discovered by Dr. Alfred François Donné, a French physician, in 1836.[1] Trichomoniasis is primarily an infection of the genitourinary tract. The urethra is the most common site of infection in men, and the vagina is the most common site of infection in women. It is most common in women and uncircumcised men. For uncircumcised men, the most common site for the infection is the tip of the penis.
Historical Perspective
Trichomonas vaginalis was first discovered by Dr. Alfred François Donné, a French physician, in 1836.[1]
Pathophysiology
Causes
Trichomoniasis is caused by the single-celled protozoan parasite, Trichomonas vaginalis. The vagina is the most common site of infection in women, and the urethra is the most common site of infection in men.
Differential Diagnosis
Trichomoniasis must be differentiated from other causes of vaginitis such as bacterial vaginosis, vulvovaginal candidiasis, and atrophic vaginitis.[2]
Epidemiology and Demographics
Risk Factors
The human genital tract is the only reservoir for this species. Trichomonas is transmitted through sexual or genital contact.[3] Hence higher prevalence is among persons with multiple sexual partners or other venereal diseases.
Natural History, Complications, and Prognsis
Diagnosis
History and Symptoms
Physical Examination
For both men and women, a health care provider must perform a physical examination and laboratory test to diagnose trichomoniasis. The parasite is harder to detect in men than in women. In women, a pelvic examination can reveal small red ulcerations (sores) on the vaginal wall or cervix.
Laboratory Findings
Diagnosis of vaginal trichomoniasis is usually performed by microscopy of vaginal secretions, but this method has a sensitivity of only approximately 60%-70% and requires immediate evaluation of wet preparation slide for optimal results.
Other Diagnostic Studies
Treatment
Medical Therapy
Trichomoniasis can usually be cured with the prescription drug, metronidazole, given by mouth in a single dose. The symptoms of trichomoniasis in infected men may disappear within a few weeks without treatment. However, an infected man, even a man who has never had symptoms or whose symptoms have stopped, can continue to infect or re-infect a female partner until he has been treated. Therefore, both partners should be treated at the same time to eliminate the parasite. Persons being treated for trichomoniasis should avoid sex until they and their sex partners complete treatment and have no symptoms. Metronidazole can be used by pregnant women. Having trichomoniasis once does not protect a person from getting it again. Following successful treatment, people can still be susceptible to re-infection.
References
- ↑ 1.0 1.1 Thorburn AL (1974). "Alfred François Donné, 1801-1878, discoverer of Trichomonas vaginalis and of leukaemia". Br J Vener Dis. 50 (5): 377–80. PMC 1045069. PMID 4138951.
- ↑ Hainer BL, Gibson MV (2011). "Vaginitis". Am Fam Physician. 83 (7): 807–15. PMID 21524046.
- ↑ "Trichomoniasis - CDC Fact Sheet". Retrieved 12 January 2011.