We're gonna move on and talk about Trichomoniasis.
This is the most common curable STD worldwide
and many men are asymptomatic.
Women will present with vaginitis related symptoms.
They might have pruritus or itching, burning when they urinate,
urinary frequency, dyspareunia.
The cervical exam or pelvic exam can reveal
malodorous greenish color frothy discharge.
And this is diagnosed based on wet prep exam
and on wet prep exam, you'll see flagellated protozoa.
So you'll see flagellated protozoa
that are gonna be swimming around on the slide.
You might also see the white blood cells as well
and the sensitivity for that is 50 to 65%.
The treatment for trichomoniasis is metronidazole or Flagyl.
You can give two grams orally one time
or you can give it for over a course of 7 days.
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.
You wanna beware or at least council a patient
of the disulfiram like reaction.
What that means is that a patient should not drink alcohol
when they're on this medication.
Metronidazole historically or can be used actually
to treat alcohol abuse.
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.
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.
It is okay to treat symptomatic pregnant women.
So if you have a woman who's pregnant
who has evidence of trichomoniasis infection,
metronidazole is okay to give orally.