Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content +++ Key Features ++ Caused by Trichomonas vaginalis Infects 3.7 million people each year in the United States Has been associated with adverse pregnancy outcomes Urethritis seen in 50% of males who have infection Male partners of females with trichomoniasis have a 22% chance of contracting infection Urethritis develops in half of males with infection Rescreening for T vaginalis at 3 months following initial infection is recommended for women due to the high rate of reinfection +++ Clinical Findings ++ Symptomatic vaginitis with vaginal itching, a green-gray malodorous frothy discharge, and dysuria Occasionally postcoital bleeding and dyspareunia may be present Vulva may be erythematous Cervix may be friable +++ Diagnosis ++ Mixing the discharge with normal saline facilitates detection of the flagellated protozoan on microscopic examination (wet preparation); sensitivity is only 60–70% Culture and nucleic acid amplification testing are available when the diagnosis is unclear Two FDA-approved, point-of-care antigen-based detection assays for T vaginalis are available However, false-positive results are problematic in populations with low disease prevalence Both antigen assays are performed on vaginal secretions Sensitivity is > 83% and a specificity is > 97% Trichomonal urethritis frequently causes a positive urine leukocyte esterase test and white blood cells on urethral smear +++ Treatment ++ Recommended regimens Metronidazole, 2 g orally as a single dose or Tinidazole, 2 g orally as single dose Alternative regimen: metronidazole, 500 mg orally twice daily for 7 days Your Access profile is currently affiliated with [InstitutionA] and is in the process of switching affiliations to [InstitutionB]. Please select how you would like to proceed. Keep the current affiliation with [InstitutionA] and continue with the Access profile sign in process Switch affiliation to [InstitutionB] and continue with the Access profile sign in process Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Error: Incorrect UserName or Password Username Error: Please enter User Name Password Error: Please enter Password Sign in Forgot Password? Forgot Username? Download the Access App: iOS | Android Sign in via OpenAthens Sign in via Shibboleth You already have access! Please proceed to your institution's subscription. Create a free profile for additional features.