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(solved) Trichimonas Vaginosis. Case Study

(solved) Trichimonas Vaginosis. Case Study

Trichimonas Vaginosis. Case Study


An 18-year-old girl arrives at her pediatrician’s office with her mother for a pre-college check-up. She has no history of medical problems. The girl admits having sex with her boyfriend for the first time two weeks ago. She complains of a yellow-green malodorous vaginal discharge that began a week ago after her mother left the room for the social history component. She supports minor pelvic pain. Mild cervical tenderness is noted during a pelvic exam. The cervix is pink, nulliparous, and inflamed, with small red punctate spots covering it. There is also a thin yellow, frothy green discharge of fishy odor. Squamous cells and numerous motile organisms are discovered in a wet prep.

Trichomonas vaginalis was found in our patient (TV).

TV is a flagellated parasitic protozoan with only humans as hosts. It has multiple flagella projecting from the anterior and posterior sides and measures 10-20 um long and 2-14 um wide. It only has one trophozoite stage and cannot survive outside its host. TV is an obligate predatory parasite that feeds on bacteria, vaginal epithelial cells, and red blood cells. It employs fermentative metabolism to generate the carbohydrates required for fuel. TV is a sexually transmitted disease, but the actual epidemiologic incidence rate is unknown because it is not reported to local health departments. Its prevalence varies greatly depending on population and location. Some studies report a prevalence of 3.1% of American pre-menopausal women (2.3% of adolescents), while the rate may be as high as 47% in specific high-risk populations. Most patients are asymptomatic; approximately one-third of females become symptomatic within six months of infection. Female symptoms include vulvar and vaginal irritation, itching, urination pain, and a diffuse, malodorous, yellow-green vaginal discharge. The cervix reddens in a punctuated pattern, resulting in the well-known strawberry cervix seen on colposcopy. Urethritis can develop in men. TV is frequently diagnosed using wet mount microscopy, which shows the protozoa moving around. However, sensitivity is relatively low, particularly among men. Nucleic acid probe detection from urine, endocervical, and vaginal swabs are thought to be more sensitive. TV can also be discovered by chance on Pap tests. Metronidazole is typically administered as a single dose. It is critical to treat partners as well, or else reinfection may occur.

Trichimonas Vaginosis. Case Study


Trichimonas Vaginosis. Case Study

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