Presentation
Her last course of metronidazole was 1 month before her presentation. There was no history of other sexually transmitted diseases. Her husband was experiencing dysuria at the time she presented to our clinic. [sti.bmj.com]
The present "gold standard" for the diagnosis of T. vaginalis is culture. [ijpmonline.org]
We studied the accuracy of the traditional wet-mount technique as compared with detection using direct immunofluorescence and culture techniques in ED patients with the presenting complaint of vaginal discharge. [ncbi.nlm.nih.gov]
Trichomonads on the wet mount mean trichomoniasis is present. Clue cells means bacterial vaginosis is present. If many Gardnerella vaginalis bacteria are present, this also may mean bacterial vaginosis is present. [northshore.org]
Entire Body System
- Laboratory Technician
If trichomonads were noted during routine urinalysis, the laboratory technician recorded this result on the clinic laboratory urinalysis form. [jamanetwork.com]
Trained laboratory technicians then explained to each participant how to self-collect a vaginal specimen using a dacron swab. [ncbi.nlm.nih.gov]
- Turkish
A Turkish study investigated the efficacy of vaginal pessaries containing metronidazole 500 mg and miconazole nitrate 100 mg, for the treatment of candidiasis, bacterial vaginosis and trichomoniasis and in mixed vaginal infections ( 38 ). [antimicrobe.org]
Cardiovascular
- Tachycardia
T he major toxicity of metronidazole is its disulfuram-like effect, consisting of tachycardia, flushing, nausea and vomiting, when taken with ethanol. As well, metronidazole and disulfuram taken together may induce an acute psychosis. [antimicrobe.org]
Skin
- Flushing
Drinking alcohol while taking either drug can cause nausea, vomiting, cramps, flushing, and headaches. During sexual intercourse, condoms should be used until the infection resolves to help prevent transmission of the infection. [merckmanuals.com]
More than half of the girls used a flush toilet. Seventy-three percent of the girls reported that they shared their bedding with someone else, most often a sister or the mother. [journals.plos.org]
- Urticaria
Adverse reactions that may occur include anaphylaxis, skin rashes, pustular eruptions, pruritis, flushing, urticaria and fever [29]. [pharmaceutical-journal.com]
The most common reactions were urticaria (47%) and facial edema (11%), based on patient history. [academic.oup.com]
The most common reactions reported from metronidazole are urticaria and facial edema, while other adverse reactions include flushing, fever and anaphylactic shock from immediate-type hypersensitivity have been reported. [bmcinfectdis.biomedcentral.com]
Urogenital
- Vaginal Discharge
The most common symptoms are an unusual vaginal discharge, vaginal itch and pain during sexual intercourse. Antibiotics are needed to treat the infection. Sexual partners should also be treated. [ada.com]
We studied the accuracy of the traditional wet-mount technique as compared with detection using direct immunofluorescence and culture techniques in ED patients with the presenting complaint of vaginal discharge. [ncbi.nlm.nih.gov]
Vaginal fluid was also examined for polymorphonuclear leucocytes. ~ Results All 156 women in the study group had vaginal discharge, of whom 69.87% had vaginal discharge with foul odour, 20.51% vaginal discharge plus itching, 5.76% vaginal discharge plus [ijmm.org]
On examination, there was severe vulvar inflammation, vestibulitis, purulent vaginal discharge with a pH of 6.0, and inflammation of the ectocervix. [sti.bmj.com]
- Dysuria
Symptoms include vaginal discharge (which is often diffuse, malodorous, yellow-green), dysuria, itching, vulvar irritation and abdominal pain. [clinicaltrials.gov]
Men are usually asymptomatic; however, sometimes urethritis results in a discharge that may be transient, frothy, or purulent or that causes dysuria and frequency, usually early in the morning. [msdmanuals.com]
Itching dysuria, and offensive, malodorous, thin, yellowish vaginal discharge were the main and consistent complaints. [ijmm.org]
Other common symptoms include vulval itching, dysuria or offensive odour. Lower abdominal discomfort can occur in some women. There may be signs of local inflammation with vulvitis and vaginitis. [patient.info]
Workup
Trichomoniasis workup. Medscape. Available online at http://emedicine.medscape.com/article/230617-workup. Accessed February 2017. (2016 November). Advances in laboratory detection of Trichomonas vaginalis (updated). [labtestsonline.it]
Epididymitis Gonococcal Infections Nonbacterial Prostatitis Pelvic Inflammatory Disease Urethritis Vaginitis Other Problems to be Considered : Bacterial vaginosis Atrophic vaginitis with secondary infection Erosive lichen planus Foreign body vaginosis WORKUP [csh.org.tw]
Treatment
It is important to be careful while diagnosing because the treatment of AV differentiates from treatment of other vaginitis. [ncbi.nlm.nih.gov]
“Centers for Disease Control and Prevention (CDC): Sexually transmitted diseases treatment guidelines, 2010”. MMWR Recomm Rep. vol. 59. 2010. pp. 1 (Updated Guidelines from the CDC which guide treatment for sexually transmitted infections.) [infectiousdiseaseadvisor.com]
Efficacy of 7-day treatment with metronidazole+miconazole (Neo-Penotran) - a triple-active pessary for the treatment of single and mixed vaginal infections. Int J Gynaecol Obstet 2001 Jul;74:35-43. [PubMed] 39. [antimicrobe.org]
Prognosis
What Is The Prognosis? Treatment with metronidazole produces a cure in about 95% of patients. Prevention Important preventive measures include regular use of latex condoms or abstaining from sexual activity. [healthychildren.org]
[…] pathogenesis disruption of this acidic environment results in vaginitis disruptive causes include menstruation sexual activity pregnancy foreign bodies sexually transmitted disease hygienic products antibiotics hypoestrogenic states ( e.g., menopause) Prognosis [medbullets.com]
Control of T vaginalis may represent an important means of slowing HIV transmission, particularly among African Americans. [37] Prognosis Recommended metronidazole therapy regimens have produced a 90-95% cure rate in randomized clinical trials. [9] The [emedicine.medscape.com]
Etiology
Although we did not test for other organisms thought to be etiologic agents of NGU, the role and potential contribution to the etiology of the clinical findings, which are termed NGU, remains speculative. [academic.oup.com]
An estimated 3 to 5 million cases of trichomoniasis occur each year in the United States. 1 The worldwide prevalence of trichomoniasis is estimated to be 180 million cases per year; and these cases account for 10% to 25% of all vaginal infections. 2 Etiology [basicmedicalkey.com]
TrichomoniasisTrichomonas vaginalis is the etiologic agent of trichomoniasisMode of infection ; STDreservoir for this species - human genital tractSexually transmitted infection of the urogenital tractVaginitis in women- site of infection –vagina,urethraUrethritis [slideshare.net]
Analogous ramifications have been postulated for T. vaginalis and a viral etiology of much greater prevalence. Persistent human papillomavirus infection factors into the development of cervical neoplasia. [clinchem.aaccjnls.org]
[…] partners antibiotic use intrauterine contraceptive device trichomoniasis multiple sexual partners history of sexually transmitted infections vulvovaginal candidiasis immunosuppression ( e.g., transplant patients and HIV infection) uncontrolled diabetes Etiology [medbullets.com]
Epidemiology
Annals of Epidemiology. 1995; 5 (4):325–332. [ PubMed ] [ Google Scholar ] [ncbi.nlm.nih.gov]
Smith, PhD, MPH, Department of Epidemiology, UNC Gillings School of Global Public Health, University of North Carolina at Chapel Hill, McGavran-Greenberg, Chapel Hill, NC 27599. E-mail: [email protected] [journals.lww.com]
In the minds of some laboratory diagnosticians, the other 3 public health importance criteria will become the subjects of additional TMA-based detection and epidemiologic data. [clinchem.aaccjnls.org]
Poole DN, McClelland RS ; Global epidemiology of Trichomonas vaginalis. Sex Transm Infect. 2013 Sep89(6):418-22. doi: 10.1136/sextrans-2013-051075. Epub 2013 Jun 6. [patient.info]
However, programmatic decisions to offer screening should be based on local epidemiologic data whenever possible. [jcm.asm.org]
Pathophysiology
3 to 5 million cases of trichomoniasis occur each year in the United States. 1 The worldwide prevalence of trichomoniasis is estimated to be 180 million cases per year; and these cases account for 10% to 25% of all vaginal infections. 2 Etiology and Pathophysiology [basicmedicalkey.com]
STD Pathophysiology STD Prevention and Treatment STD Diagnosis History of Sexually Transmitted Disease [news-medical.net]
Useful For Suggests clinical disorders or settings where the test may be helpful Detection of Trichomonas vaginalis in male patients Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory [mayocliniclabs.com]
Useful For Suggests clinical disorders or settings where the test may be helpful Detection of Trichomonas vaginalis in female patients Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory [mayomedicallaboratories.com]
Prevention
It is important to tell and treat the sexual partner(s) to prevent re-infection and further spread of the infection. Prevention Practicing safe sex can prevent trichomonas infection. [ada.com]
Always using a condom can help prevent this infection. One dose of metronidazole or tinidazole taken by mouth cures most women. [merckmanuals.com]
NIMH Collaborative HIV/STD Prevention Trial Group. Selection of populations represented in the NIMH collaborative HIV/STD prevention trial. AIDS. 2007; 21 (supplement 2):S19–S28. [ PubMed ] [ Google Scholar ] 13. [ncbi.nlm.nih.gov]
Centers for Disease Control and Prevention. Available online at http://www.cdc.gov/std/trichomonas/STDFact-Trichomoniasis.htm. Accessed February 2017. [labtestsonline.it]