Diagnosis & Management:

• Introduction

• Contents

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• Clinical assessment guidelines

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Trichomonas contents

Essential facts

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Diagnosis and management

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Trichomoniasis
Diagnosis and management

Diagnosis

Management

Health advice

Follow-up

Diagnosis

Detection of trichomonads in a wet preparation or smear. In males, microscopic examination of centrifuged urine may reveal trichomonads, but this test lacks sensitivity.

Management

Treatment

Standard therapy

metronidazole 400 mg orally 12 hourly for 5 days (ADEC B2)

or

metronidazole 2 g orally as one dose

or

tinidazole 2 g orally as one dose

Alcohol should not be consumed during treatment with metronidazole or tinidazole and for 3 days after treatment. 

Patient education

The following points should be discussed:

• The nature of the infection

• The need to treat regular sex partners 

• Men are usually asymptomatic and it is rare for trichomonads to be observed

• Abstinence from sex until the regular partner is treated and cured. If a microbiologic test of cure is unavailable, sexual activity may resume when therapy has been completed and both patient and partner are with out symptoms

• Provide literature on trichomoniasis.

Contact tracing

Although trichomoniasis is not a notifiable disease contacts should be tested and treated.

Follow-Up

One week after completion of therapy:

• Check that regular sex partner has been treated (if applicable)

• Check on compliance for multi-dose regimen

• Evaluate symptoms and signs

• Check reaction to medication

• Enquire about sexual activity since treatment

• Perform test of cure

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