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Clinical Features:
Trichomonas vaginalis infection in women is frequently symptomatic.
Vaginitis with a purulent discharge is the prominent symptom, and can be accompanied by vulvar and cervical lesions, abdominal pain, dysuria and dyspareunia.
The incubation period is 5 to 28 days. In men, the infection is frequently asymptomatic; occasionally, urethritis, epididymitis, and prostatitis can occur.
Laboratory Diagnosis:
Microscopic
examination of wet mounts may establish the diagnosis by detecting actively motile
organisms. This is the most practical and rapid method of diagnosis (allowing
immediate treatment), but it is relatively insensitive. Direct immunofluorescent
antibody staining is more sensitive than wet mounts, but technically more complex.
Culture of the parasite is the most sensitive method, but results are not available for 3
to 7 days. In women, examination should be performed on vaginal and urethral
secretions. In men, anterior urethral or prostatic secretions should be examined.
Diagnostic findings
Treatment:
Treatment should
be implemented under medical supervision, and should include all sexual
partners of the infected persons. The drugs of choice for treatment
are metronidazole and tinidazole; therapy is usually highly successful.
Strains of Trichomonas vaginalis resistant to both drugs
have been reported. For additional information, see the
recommendations in
The Medical Letter (Drugs for Parasitic Infections).
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