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Trichomoniasis

Michael J. Arnold, MD Reviewed 06/2019
 


BASICS

DESCRIPTION

  • Sexually transmitted urogenital infection caused by a pear-shaped, parasitic protozoan

  • Causes vaginitis/urethritis in women, nongonococcal urethritis in men

  • In pregnancy, increases ris...

DIAGNOSIS

HISTORY

  • Women—up to 80% may be asymptomatic.

    • Yellow-green, malodorous vaginal discharge

    • Vulvovaginal pruritus

    • Dysuria

    • Symptoms often worsen during menses.

  • Men—80% are asymptomatic.

    • Dysuria

    • Urethral ...

TREATMENT

  • Symptomatic individuals require treatment.

  • Sexual partners should be treated presumptively.

  • Patients should abstain from sexual intercourse during treatment and until they are asymptomatic.

GENERAL MEASURES

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • If symptoms persist after initial treatment, repeat wet mount or other testing.

  • Retest women for T. vaginalis recommended within 3 months of treatment; data insuff...

REFERENCES

1
Bouchemal K, Bories C, Loiseau PM. Strategies for prevention and treatment of Trichomonas vaginalis infections. Clin Microbiol Rev.  2017;30(3):811–825. [View Abstract on OvidMedline]
...

ADDITIONAL READING

  • Chernesky M, Jang D, Smieja M, et al. Urinary meatal swabbing detects more men infected with Mycoplasma genitalium and four other sexually transmitted infections than first catch ur...

CODES

ICD10

  • A59.9 Trichomoniasis, unspecified

  • A59.03 Trichomonal cystitis and urethritis

  • A59.01 Trichomonal vulvovaginitis

  • A59.09 Other urogenital trichomoniasis

  • A59.8 Trichomoniasis of other sites

  • A59.02 T...

CLINICAL PEARLS

  • Both partners need to be treated for trichomoniasis.

  • Retest women within 3 months of treatment.

  • Avoid alcohol during treatment.

  • Treatment in pregnancy does not reduce risk of adverse preg...

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