trichomoniasis

TRICHOMONIASIS
Dr. Kristina Nadeak, SpKK
SEXUALLY TRANSMITTED INFECTION AND TREPONEMATOSIS SUB DIVISION
DEPARTEMENT OF DERMATOLOGY AND VENEREOLOGY
FACULTY OF MEDICINE USU/H. ADAM MALIK GENERAL HOSPITAL
MEDAN
DEFINITION
Infectious protozoas disease caused by
Trichomonas vaginalis.
vaginalis.
Usually transmitted by sexual route.
Infected commonly lower urogenital tract (♀
(♀ & ♂).
Parasite can be found in the vagina, urethrae,
bladder and the paraurehtra canal.
ETIOLOGY
Trichomonas vaginalis (Donne
(Donne--1836)
Protozoa flagelata with 4 flagellas in the anterior
side.
500C → †, 00C → survive in 5 days.
Incubation periode : 4 – 28 days.
CLINICAL FEATURE IN WOMEN
Complaint
Complaint :
1.
None
2.
Discharge
odorous
iritative/itch
3.
dispareunia
4.
Disuria
5.
Lower abdomen discomfort
Simptom :
1.
None
2.
Diffuse vulvae erithema
3.
Excessive discharge
yellow, green
foamy
4.
Vaginal wall inflammation
5.
Strawberry cervix
direct examination
colposcopy examination
Prevalence (%)
9 – 56
50 – 75
10 – 67
23 – 82
10 – 50
30 – 50
5 – 12
- 15
10 – 37
5 – 42
8 – 50
20 – 75
1–2
- 45
CLINICAL FEATURE IN MEN
10 – 50% without obvious simptom.
Discharge (50(50-60%).
Disuria, itch sensation in the urethra.
Balanopostitis ± with erosion and pain in the glans
and preputium.
LABORATORIUM EXAMINATION
Fresh sample direct examination (wet sample) with
normal saline.
Cultured in the Feinberg/Kupferberg media
DIFFERENTIAL DIAGNOSIS
♂ : - Urethritis Non Spesific
- Gonorrheae
- Traumatic urethritis
♀ : - Gonorrheae
- Candidiasis vagina
- Foreign body in the vagina
COMPLICATION
♂ : - Involved the prostate
- Cystitis
- Epididimitis
♀ : - Bartholinitis
- Urethritis
- Cystitis
TREATMENT
o
o
o
o
2 gr Metronidazole, or 2 x 0,5 gr → 7 days.
Sexual partner : must be treated
Contra indication : fisrt trimester pregnancy
Neonate > 4 months : metronidazole 5
mg/kgBB/oral, 3 x/days – 5 days.