Thursday, December 11, 2014

A 17-year-old woman presents to the clinic complaining of vaginal itchiness and malodorous discharge.

A 17-year-old woman presents to the clinic complaining of vaginal itchiness and malodorous discharge.

She is sexually active with multiple partners, and she is interested in getting tested for sexually transmitted diseases.

A wet-mount microscopic examination is performed, and trichomonal parasites are identified.

Which of the following statements regarding trichomoniasis is true?

A. A majority of women are asymptomatic.
B. No treatment is necessary because the disease is self-limited.
C. The patient’s sexual partner need not be treated.
D. Trichomoniasis can only be spread sexually.
E. Trichomoniasis is 100% sensitive to metronidazole







The answer is D. Trichomoniasis is transmitted via sexual contact with
an infected partner. Many men are asymptomatic but may have symptoms of urethritis,
epididymitis, or prostatitis. Most women have symptoms of infection that include
vaginal itching, dyspareunia, and malodorous discharge.

These symptoms do not distinguish Trichomonas infection from other forms of vaginitis, such as bacterial vaginosis.

Trichomoniasis is not a self-limited infection and should be treated for symptomatic and public health reasons. Wet-mount examination for motile trichomonads has a sensitivity of 50% to 60% in routine examination. Direct immunofluorescent antibody staining of secretions is more sensitive and can also be performed immediately.

Culture is not widely available and takes 3 to 7 days. Treatment should consist of metronidazole either as a single 2-g dose or 500-mg doses twice daily for 7 days; all sexual partners should
be treated. Trichomoniasis resistant to metronidazole has been reported and is managed
with increased doses of metronidazole or with tinidazole.

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