Trichomoniasis

What it is

Trichomoniasis is a vaginitis, and the organism is a parasite, Trichomonas vaginalis. It is an STD, which candida and bacterial vaginosis are not, so test for HIV, syphilis and GC as well. The two non-sexually transmitted causes of discharge stand next to it. Vulvovaginal candidiasis: a fungus, Candida albicans, vaginal discharge white, thick and cheesy, itchy, common in pregnancy and in the immunocompromised, and in those on AB or on contraception. Bacterial vaginosis: Gardnerella vaginalis, clear, white or gray discharge with a fishy smell, no pruritus, no pain and no bleeding, and it is the one named by the Amsel criteria, which are four:

1. Grey whitish discharge.
2. Vaginal pH above 4.5.
3. Clue cells on wet mount.
4. A positive whiff test.

The organism itself is a flagellated, single-celled anaerobic protozoa that may infect the cervix, urethra and vagina, and in the male it is carried in the urethra or prostate. Transmission is by sexual contact most commonly, and rarely via contaminated objects such as wet towels or shared bathing. About 60% of patients also have BV, and patients should be tested for other STDs.