Clinical Presentation of Trichomoniasis

General

• Asymptomatic Signs

• Strawberry cervix (women)

• Colpitis macularis (women)

• Prostatitis or epididymitis (men) Symptoms

• Vaginal/vulvar erythema

• Excessive yellow-green discharge

• Vulvar itching

• Urethral discharge or irritation

• Vaginal pH greater than 4.5

Metronidazole

Metronidazole may be administered orally as a single 2-g dose or 500 mg twice daily

for 7 days. Pregnant women should be prescribed the single dose of metronidazole. Cure rates are greater than 90% when metronidazole is administered as either a single 2-g dose or a 7-day regimen. Possible adverse effects include an unpleasant metallic taste, reversible neutropenia, urticaria, rash, flushing, dry mouth, darkened urine, and a disulfiram-like reaction.

Tinidazole

Tinidazole, a second-generation nitroimidazole with protozoal and anaerobic activity,

has been available outside the United States for over 30 years. As a single 2-g dose, tinidazole has an efficacy equivalent to a 2-g dose of metronidazole. Tindazole also has a longer half-life than metronidazole, 14 and 7 hours respectively, and penetrates into male reproductive tissue better than metronidazole.

Tinidazole is effective for metronidazole-resistant trichomoniasis. Possible side effects include a metallic taste, dizziness, loss of coordination, seizures, severe diarrhea, darkened urine, nausea, vomiting, and a swollen or discolored tongue.

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