Protozoan Sexually Transmitted Infections
QUICK LOOK AT THE CHAPTER AHEAD
Trichomonas vaginalis is an organism that lives in the female genitalia and is a sexually transmitted infection. It has a characteristic green or yellow frothy vaginal discharge and most women are unaware they have been infected until they become symptomatic. There is no incubation period for it. Easily treated with a single dose antibiotic, it is important that both or all partners are treated before having sexual intercourse again.
Trichomoniasis is a disease cause by infection with a species of anaerobic one-celled protozoan with flagellate, Trichomonas vaginalis (Table 22-1). Approximately 5 million cases occur annually and are transmitted during penile-vaginal intercourse and can facilitate HIV transmission. The organism lives in the urethra and vagina of women and in the urethra and prostate gland of men. There is no incubation period. It is not a reportable disease.
Signs and symptoms include a characteristic frothy yellow or green vaginal discharge that is malodorous and worsens after menstruation. Women frequently complain of dyspareunia or dysuria, although men are generally asymptomatic with rare reports of urethritis or prostatitis. On examination, a woman’s cervix may be friable and have hallmark “strawberry spots” or petechiae. The pH of the vagina will be high.
Diagnosis is made based on a wet mount, but there is also a culture available that has the highest sensitivity and specificity. Pap smears or Thin preps are not reliable diagnostic tests for trichomoniasis.
Pap smears or Thin preps are not reliable diagnostic tests for trichomoniasis.Metronidazole 2 g single dose is the most commonly recommended antiprotozoal and antibacterial agent. Intravaginal preparations are not recommended. Both partners need to be treated and should be advised to avoid alcohol during treatment and for 24 hours after due to the interaction of alcohol with the medication.
Both partners need to be treated and should be advised to avoid alcohol during treatment and for 24 hours after due to the interaction of alcohol with the medication.Table 22-1 Types of Protozoan STIs | ||||||||||
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SECTION VIII ♦ REVIEW QUESTIONS
1. Which of the following statements is true regarding HPV?
a. All women with HPV will go on to develop cervical cancer.
b. All women with HPV will develop genital warts.
c. Only a few strains of HPV are considered oncogenic.
d. Only men with HPV can pass the virus onto their partners.
View Answer
1. The answer is c. Rationale: Only a few strains are considered oncogenic. Not all women who are infected with HPV will develop cervical cancer and only certain strains of HPV cause genital warts.
2. Risk factors for acquiring a sexually transmitted infection include all of the following except:
a. Hormonal imbalances
b. Substance abuse
c. Multiple sex partners
d. Lack of contraception
View Answer
2. The answer is a. Rationale: Hormonal imbalances do not contribute to acquiring an STI.
3. The most common bacterial STI is:
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