Trichomoniasis (Emergency Medicine)

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.