Daily Bolus of LR: Trichomoniasis

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March 3, 2011 by dailybolusoflr

Trichomoniasis is the most common curable STD in young women.  Trichomonas vaginalis is a single celled protozoa parasite which causes the infection.


The two common sites of infection are:

·         In women- the vagina

·         In  men- the urethra



·         Men are often asymptomatic but if symptoms are present are often representative of urethral irritation (dysuria, pain with ejaculation and less likely discharge).

·         The classic finding in women is a frothy yellow-green discharge with a foul odor.  Women may complain of pain with intercourse, dysuria, vaginal itching or discharge or less likely, lower abdominal pain.



·         The treatment for trichomoniasis is a single oral dose of metronidazole (2 grams).

·         Alternative treatment recommendations is 500mg orally bid for 7 days or 1g orally bid for one day. 

·         The recommendation does exist to hold treatment until after the first trimester.


Remember in these patients to test for other STDs and counsel your patients to abstain from unprotected sex with their partner(s) until they also have been treated.  The risk of re-infection exists in these cases.






Linda Regan, MD FACEP

Program Director, Emergency Medicine Residency

Johns Hopkins Medical Institutions


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