Trichomonas Vaginalis Infec'on in a Ter'ary Care Vagini's Center M. Kea'ng, P. Nyirjesy
Department of Obstetrics and Gynecology, D
rexel U
niversity C
ollege o
f M
edicine Background Trichomonas is one of the most common sexually transmiHed diseases with an es'mated 7.4 million new cases annually in the U.S.1 and up to 180 million persons affected annually worldwide.2 It is not a reportable infec'on therefore data about its prevalence, rates of recurrence, and resistance is incomplete. Objec'ves •
Determine features of Trichomonas vaginalis Infec'on (TVI) in a referral-­‐
based vagini's clinic •
Summarize tests used to establish diagnosis and document eradica'on •
Outline successful treatment regimens Methods •
Results Demographics/Symptoms -­‐ Out of an es'mated 4,000 new pa'ent visits, 80 subjects iden'fied -­‐ 20 referred with known TVI, 60 newly diagnosed -­‐ Average age of 40 with range from 18 to 70 years old -­‐ Most commonly reported symptoms included: vaginal discharge (97%), vaginal odor (75%), and vaginal itching (71%) Treatment regimens 1) Standard Metronidazole or Tinidazole 2gm orally Metronidazole 500mg BID orally x 7 days 2) High Dose Tinidazole 1gm BID or TID orally + 500mg tablet vaginally at bed'me x 14 days Metronidazole 1gm TID orally + 500mg tablet vaginally at bed'me x 14 days 3) Combina'on Tinidazole 1gm TID orally + Paromomycin 6.25% cream vaginally at bed'me x 14 days Diagnosis of Known Infec:on Retrospec've review of all pa'ents with TVI, based on ICD-­‐9 codes, seen Collected informa'on about: demographics, symptoms, physical exam findings, diagnos'c tests, and treatment regimens References 1.  Weinstock H, Berman S, Cates W. Sexually transmiHed disease among American youth: incidence and prevalence es'mates, 2000. Perspect Sex Reprod Health 2000; 36:6-­‐10. 2. Lara-­‐Torre E, Pinkerton JS. Accuracy of detec'on of Trichomonas vaginalis organisms on a liquid-­‐based Papanicolaou smear. Am J Obstet Gynecol Treatment of New Infec:on Follow-­‐Up -­‐ 60 subjects (80%) had a follow-­‐up visit and 100% of those were cured -­‐ 92% had eradica'on documented with PCR or culture Conclusions at the Drexel Vagini's Center between January 2008 and November 2013 •
Diagnosis of New Infec:on Treatment of Known Infec:on 1)  Trichomoniasis is an uncommon condi'on in a ter'ary care vagini's center. 2)  Reliance on wet mount alone would have missed 64% of cases. 3) Pa'ents with allergy can be treated successfully acer desensi'za'on. 4) In cases of resistance, treatments exist which can affect a cure every 'me. Acknowledgements M. Kea'ng was supported by an IDSOG Trainee Scholarship, sponsored by