What Are the Most Common Treatments for Trichomoniasis?

Trichomonas is a general term for diseases caused by trichomonas vaginalis, human trichomoniasis, and oral trichomoniasis in the human urogenital tract, intestinal tract, and oral cavity. Genital contact transmission is the most common non-viral sexually transmitted infection and is contagious. Trichomonas vaginitis caused by Trichomonas vaginalis is the most common.

Basic Information

English name: trichomoniasis
Visiting department: Gynecology
Common causes: Flagella trichomonas invading the vagina

Common symptoms: Increased yellow-green foam leucorrhea, itching of the vulva
Contagious: Have
way for spreading: Sexual or genital contact

Causes of trichomoniasis

Vaginal trichomoniasis is caused by flagella trichomonas invading the vagina. Trichomonas vaginalis was first discovered in women's vaginal secretions by Donne (1836). The worms, like human trichomoniasis and oral trichomoniasis, only have trophozoites and no cysts. Typical ones are pear-shaped or oval, with a size of 9.7 (4.5-19) m × 7 (2.5-12.5) m. With its four flagella at the front, it swings forward and moves in a spiral motion with wave film motion.

Trichomonas vaginalis is suitable to grow in a humid environment with a temperature of 25 to 40 ° C and a pH of 5.2 to 6.6, and does not grow in an environment below pH 5 or above pH 7.5. The parasite is a facultative anaerobic parasite, which adapts to parasitizing in the relatively hypoxic vagina and can reproduce rapidly. It mainly parasitizes in the vagina and often invades the urethra or paraurethral glands, even the bladder and renal pelvis. In the male genitourinary system, the prostate is most common, and it can also be parasitic in the urethra or foreskin folds.

Clinical manifestations of trichomoniasis

1. The incubation period is 4-28 days, and some patients are asymptomatic at the beginning.

2. The main symptoms are an increase in yellow-green foam leucorrhea and itching of the vulva. The leucorrhea is thin and has a fishy odor. If it is combined with a bacterial infection, it is a purulent leucorrhea with an odor. Itching is mainly in the vaginal opening and vulva, and burning pain and sexual intercourse are also common. Vaginal examination showed vaginal mucosa and cervical swelling, bleeding "strawberry-like spots", and vaginal tenderness.

3. Trichomonas vaginalis, if parasitic in the urethra and bladder, can produce trichomoniasis urethral cystitis. Patients have symptoms such as frequent urination, urgency, dysuria, urinary retention and urethral swelling. Trichomonas infection in men, with severe urethritis and cystitis.

4. Most people do not show clinical symptoms after infection with this worm. They are called asymptomatic carriers. This carrier is not only a source of infection, but also when the conditions are appropriate, the carrier should also be treated.

Trichomoniasis test

Secretory examination

Take vaginal secretions from the posterior fornix and vaginal wall, and use microscopic examination by hanging drop method or smear staining method to find the active vaginal trichomoniasis.

2. Pathogen inspection

Check for pathogens by culturing with liver infusion or infiltration medium.

3. stool test

Check for trichomoniasis by taking stool or bile.

4. Alveolar pus examination

Take alveolar pus to check oral trichomoniasis.

Trichomoniasis diagnosis

Symptoms

Diagnosis of vaginal trichomoniasis with typical symptoms is not difficult. Typical symptoms can be used as a basis for clinical diagnosis, even if trichomoniasis is not found. Atypical patients and people with worms should rely on the examination of trichomoniasis as the basis for diagnosis.

2. check

After the vaginal secretions taken from the posterior fornix are suspended in saline, there is no need to stain, and the diagnosis can be made immediately by ordinary microscopy. It is easy to observe the rapid extension of flagella and the sprinting activity of oval protozoa. Culture is more sensitive than direct microscopy, and trichomoniasis is often diagnosed with Pap smears. Relevant tests should be done to rule out gonorrhea, chlamydia, and other sexually transmitted diseases.

Trichomoniasis treatment

Trichomonas vaginitis can have urinary tract, paraurethral gland, and vestibular trichomoniasis infections at the same time. To cure this disease, systemic medication is needed. The main treatment drugs are metronidazole and tinidazole.

Systemic medication

For the first treatment, you can choose metronidazole, single oral administration; or tinidazole, single oral administration; or metronidazole, twice daily, for 7 days. The cure rate of oral drugs is 90% to 95%. Gastrointestinal reactions such as loss of appetite, nausea, and vomiting are occasionally seen after taking the drug. In addition, occasional headaches, rashes, and decreased white blood cell counts should be discontinued. It is forbidden to drink alcohol during metronidazole administration and within 24 hours of withdrawal, and during the 72 hours of tinidazole administration, and breastfeeding is not suitable for breastfeeding.

2. Treatment of sexual partners

Sex partners should be treated at the same time, and unprotected sex should be avoided before cure.

3. Follow-up and management of treatment failure

Trichomonas vaginitis has a high reinfection rate, and sexually active women need to be re-screened 3 months after the initial infection. Failure of a single oral treatment of metronidazole and exclusion of reinfection can increase the duration and dose of metronidazole. Repeated application of metronidazole 2 times a day for 7 days; or tinidazole, a single oral administration. If the treatment still fails, you can take metronidazole orally once a day for 5 days; or tinidazole once a day for 5 days.

4.Treatment of Pregnancy with Trichomonas Vaginitis

Trichomonas vaginitis during pregnancy can cause premature rupture of membranes, premature birth and low birth weight infants. Treatment of symptomatic trichomoniasis vaginitis during pregnancy can reduce symptoms, reduce transmission, and prevent respiratory and reproductive tract infections in newborns. Protocol: metronidazole, or metronidazole, twice daily for 7 days.

5. Precautions in treatment

To avoid repeated infections, underwear and washed towels should be boiled for 5-10 minutes to eliminate pathogens. Emphasize the treatment of sexual partners and pay attention to other sexually transmitted diseases.