Trichomoniasis (Emergency Medicine)

by Sharon Bord, MD

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    00:01 We're gonna move on and talk about Trichomoniasis.

    00:04 This is the most common curable STD worldwide and many men are asymptomatic.

    00:10 Women will present with vaginitis related symptoms.

    00:14 They might have pruritus or itching, burning when they urinate, urinary frequency, dyspareunia.

    00:20 The cervical exam or pelvic exam can reveal malodorous greenish color frothy discharge.

    00:27 And this is diagnosed based on wet prep exam and on wet prep exam, you'll see flagellated protozoa.

    00:34 So you'll see flagellated protozoa that are gonna be swimming around on the slide.

    00:39 You might also see the white blood cells as well and the sensitivity for that is 50 to 65%.

    00:46 The treatment for trichomoniasis is metronidazole or Flagyl.

    00:52 You can give two grams orally one time or you can give it for over a course of 7 days.

    00:58 Now again, we talked about the fact that giving a medication one time for a dose in the Emergency Department potentially may have benefit over sending home a patient with medication for 7 days because over a course of 7 days, that patient might not necessarily be able to be compliant with their treatment.

    01:17 You wanna beware or at least council a patient of the disulfiram like reaction.

    01:22 What that means is that a patient should not drink alcohol when they're on this medication.

    01:27 Metronidazole historically or can be used actually to treat alcohol abuse.

    01:32 So patients who drink alcohol regularly can sometimes be given metronidazole and what happens is if you drink alcohol when you're on this medication, it will make you have a lot of nausea and vomiting.

    01:44 So definitely talk to patients about it, have that discussion so they know when they're taking it not to drink any alcohol because it can make them really quite sick.

    01:53 It is okay to treat symptomatic pregnant women.

    01:56 So if you have a woman who's pregnant who has evidence of trichomoniasis infection, metronidazole is okay to give orally.

    About the Lecture

    The lecture Trichomoniasis (Emergency Medicine) by Sharon Bord, MD is from the course Abdominal and Genitourinary Emergencies.

    Included Quiz Questions

    1. Trichomoniasis
    2. Herpes
    3. Gonorrhea
    4. Syphilis
    5. Chlamydia
    1. Wet prep exam
    2. FTA-ABS
    3. VDRL test
    4. NAAT
    5. Microagglutination testing

    Author of lecture Trichomoniasis (Emergency Medicine)

     Sharon Bord, MD

    Sharon Bord, MD

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