Trichomoniasis overview
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Trichomoniasis is a common sexually transmitted disease that affects 7.4 million previously unaffected Americans each year. It is caused by a single-celled protozoan parasite Trichomonas vaginalis. Trichomoniasis is primarily an infection of the genitourinary tract. The urethra is the most common site of infection in men, and the vagina is the most common site of infection in women. It is most common in women and uncircumsized men. For uncircumsized men, the most common site for the infection is the tip of the penis.
Causes
Trichomoniasis is caused by the single-celled protozoan parasite, Trichomonas vaginalis. The vagina is the most common site of infection in women, and the urethra (urine canal) is the most common site of infection in men.
Risk Factors
Higher prevalence among persons with multiple sexual partners or other venereal diseases.
Diagnosis
Physical Examination
For both men and women, a health care provider must perform a physical examination and laboratory test to diagnose trichomoniasis. The parasite is harder to detect in men than in women. In women, a pelvic examination can reveal small red ulcerations (sores) on the vaginal wall or cervix.
Laboratory Findings
Diagnosis of vaginal trichomoniasis is usually performed by microscopy of vaginal secretions, but this method has a sensitivity of only approximately 60%-70% and requires immediate evaluation of wet preparation slide for optimal results.
Treatment
Medical Therapy
Trichomoniasis can usually be cured with the prescription drug, metronidazole, given by mouth in a single dose. The symptoms of trichomoniasis in infected men may disappear within a few weeks without treatment. However, an infected man, even a man who has never had symptoms or whose symptoms have stopped, can continue to infect or re-infect a female partner until he has been treated. Therefore, both partners should be treated at the same time to eliminate the parasite. Persons being treated for trichomoniasis should avoid sex until they and their sex partners complete treatment and have no symptoms. Metronidazole can be used by pregnant women. Having trichomoniasis once does not protect a person from getting it again. Following successful treatment, people can still be susceptible to re-infection.