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Tricho Moni As Is
Tricho Moni As Is
INTRODUCTION
TRICHOMONAS VAGINALIS
CLASSIFICATION
T. vaginalis is a parasitic protozoan, and the taxonomic position is based on the classification
scheme by Dyer , in which protozoa with the “9 + 2” flagellum fall into the phylum
Zoomastigina.
Species: Trichomonas vaginalis
LIFECYCLE
vast majority of infections are a result of direct sexual contact from person to person. As
a result, abstinence is obviously almost 100% effective as a preventative. Proper and consistent
condom usage is also effective, but uncovered areas can still transmit the parasite.
EPIDEMIOLOGY
Demographic factors
The following demographic factors may affect incidence and prevalence of trichomoniasis:
Age
Gender
Race
RISK FACTORS
CAUSES
Anal sex.
Oral sex.
Genital touching (skin-to-skin contact without ejaculation)
PATHOPHYSIOLOGY
Trichomonas is a motile organism with a size comparable to a white blood cell. It has at
least 4 flagella that provide undulating motility. The organism resides in the lumen of the
urogenital tract. The organism releases cytotoxic proteins that destroy the epithelial lining.
During an infection, the vaginal pH usually increases.
SYMPTOMS
The majority of women (85%) and men (77%) with trichomoniasis are asymptomatic. One-third
of asymptomatic women become symptomatic within 6 months. Common symptoms of
trichomoniasis in women include:
DIAGNOSIS
History
It is critical to collect a detailed and thorough sexual history from the patient. Specific areas
of focus when obtaining a history from the patient include:
Physical Examination
Appearance
LABORATORY FINDINGS
Microscopy
Leukocytes
Culture
Historically, culture has been the gold standard for diagnosis of trichomoniasis.
However, sensitivity is somewhat low (70-89%).
Nucleic acid probe techniques, the most sensitive tests, are moderately priced and fast,
but they require instrumentation and thus are not considered point-of-care. The
APTIMA Trichomonas vaginalis Assay (Hologic Gen-Probe, San Diego, CA) was FDA-cleared
in 2011 for use with urine, endocervical, and vaginal swabs, and endocervical specimens
collected in the Hologic Preserve Cyt solution (ThinPrep) from females only. Sensitivity is 95–
100% and specificity is also 95–100%.
Another diagnostic test that may be helpful in the diagnosis of trichomoniasis is the whiff test.
Whiff test
Vaginal infection with trichomonas vaginalis alters the vaginal pH from acidic to basic.
The whiff test is based on the addition of 10% potassium
hydroxide to vaginal secretions. Vaginal pH >4.5 gives off a strong, fishy odor based on the
presence of amines.
Another rapid test for the qualitative detection of T. vaginalis DNA and can yield results
<40 minutes after specimen collection. This assay is FDA cleared for diagnosing T.
vaginalis from female vaginal and urine specimens from asymptomatic and symptomatic women
with sensitivity >98%, compared with NAAT for vaginal specimens, and >92%
for urine specimens
Another rapid test providing qualitative detection of T. vaginalis that has been FDA
cleared for vaginal specimens from symptomatic and asymptomatic women, with sensitivity of
90.7% and specificity of 98.9%, compared with NAAT.
MEDICAL THERAPY
Antimicrobial therapy is the standard of care for trichomoniasis in both genders once the
diagnosis has been confirmed. The symptoms of trichomoniasis in infected men may disappear
within a few weeks even without treatment, but asymptomatic men may continue to be infectious
and should therefore be treated.
Antimicrobial Regimen
T. vaginalis infection in women
T. vaginalis infection in men
Pregnant women
Treatment failure:
In a woman after completing a regimen and has been re-exposed to an untreated partner
Preferred regimen: Metronidazole 500 mg PO bid for 7 days
In a woman after completing a regimen and no re-exposure has occurred:
Preferred regimen (1): Metronidazole 2 g PO for 7 days
Preferred regimen (2): Tinidazole 2 g PO for 7 days
In men after completing a regimen and has been re-exposed to an untreated partner
Follow-up
Patients with trichomoniasis are best managed by an interprofessional team. While most
patients are initially seen by the primary clinician, the role of the infectious disease expert
and gynecologist are invaluable.
If a diagnosis of trichomoniasis is made in urgent care or emergency department, the
patient's primary care clinician or obstetrics and gynecology clinician should be notified.
This communication is helpful in care coordination and helps ensure a test of cure is
completed. Patients diagnosed with trichomoniasis will also need to be tested for other
STIs, including HIV. The patient's primary care provider may complete this testing, or
the patient may seek testing at an STI clinic.
When completing a pelvic examination to collect vaginal swabs or completing a
bimanual examination to determine if pelvic inflammatory disease is a concern, the
recommendation is to have a chaperone, preferably a female. Often, in the emergency
department, this will be a female nurse or technician. Clinicians should document the
chaperone in the patient's health record.
Patient education is vital. The infectious disease nurse should educate the patient on the
use of barrier contraception and be compliant with treatment. In addition, the sexual
partner must be sought and treated otherwise the cycle of transmission continues. Finally,
clinicians should rescreen sexually active women after 12 weeks to ensure a complete
cure.
Open communication between the team members is vital to ensure that the patient
receives the standard of care treatment and complete cure.
PREVENTION
To prevent infection or reinfection, any sexual partners should also receive treatment.
Ways of preventing the risk of infection or reinfection include:
limiting the number of sexual partners
avoiding sex for 7–10 days after treatment for trich
not using a douche, as this can affect the healthy bacteria in the vagina
limiting or avoiding the use of recreational drugs and alcohol, as these increase the risk of
unsafe sex
using a condom for protection during sex
A condom can prevent transmission to some extent, but it is not fully reliable because the
parasite can pass from person to person on areas of the body that it does not cover.
Anyone who has symptoms or thinks that they have been exposed to trich should speak to
a doctor.
COMPLICATIONS
preterm birth
early rupture of the membrane
low birth weight in newborns
infertility
A woman can sometimes pass on the infection to the newborn during delivery, but this is rare.
Other problems
Trich may increase the risk of reproductive tract infections.
DIFFERENTIAL DIAGNOSIS
bacterial vaginosis,
vulvovaginal candidiasis, and
atrophic vaginitis.
JOURNAL
1.STUDY THE EFFECT OF MATERIAL MICROSAFE FROZEN IN THE
TREATMENT OF TRICHOMONAS GALLINUM AGAINST THE PIGEONS
Trichomonas gallinae is a single-celled protozoan parasite inhabiting in the upper
digestive tract of many birds but mostly in pigeon squabs where it causes avian trichomoniasis.
It's a protozoan flagellate parasite causes avian disease usually in the back of the throat,
esophagus and disease in the bathroom usually called the scourge. For the treatment use
medications such as anti-protozoan metronidazole 2-amino-5-nitrothiazole and metronidazole,
also used the image currently being used on a large scale, and show case low efficiency and
resistance. In recent years, for the treatment of infected birds with the avian. If the bird is
shortness of breath or cannot swallow food until death. Micro safe: is safe in water, harmless to
humans, non-toxic, non-flammable, non-corrosive and does not contain any alcohol. It has
absolutely no side effects and is non-irritating to eye and skin, the main ingredient material is
purified super oxidized water (99.97%). In the result we found in the first and second day
weakness and the few number of parasite while in the third day we see the elimination of the
parasite and without any signs of infected birds , the proportion of treatment 80% of the total
compared with the control group under the level of significant different 0.05%, which was given
the new drug without easing and we did not show any apparent signs of harm to the infected
birds either the fourth group, which was given a drug metronidazole ,the significant difference
has been given 0.045 to eliminate the parasite within a period of four days, with the advent met
with signs of lethargy in some birds infected treatment while the third group was given a
significant difference 0.05 to eliminate the parasite doses microsafe frozen daily, morning and
night for four days without the emergence of any satisfactory only signs of a lack of appetite for
the birds. The aim of the study: the use of a new drug for the treatment of hairy T.galline parasite
that has been frozen microsafe in vivo and in vitro.
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WEBSITE
1. https://www.wikidoc.org/index.php/Trichomoniasis_medical_therapy
2. https://emedicine.medscape.com/article/230617-overview#a3
3. https://my.clevelandclinic.org/health/diseases/4696-trichomoniasis
4. https://www.nhs.uk/conditions/trichomoniasis/
JOURNAL REFERENCE