{
 "topic": "Trichomoniasis",
 "slug": "trichomoniasis",
 "category_id": 14996,
 "passage_count": 14,
 "source_chars": 11260,
 "enough_material": true,
 "references": [
  {
   "title": "Red Book 2018",
   "author": "Kimberlin, David W.; Long, Sarah S.; Brady, Michael T.",
   "pages": [
    220,
    328,
    1258
   ]
  },
  {
   "title": "Kliegman R. Nelson Textbook of Pediatrics 2-Volume Set 22ed 2024",
   "author": null,
   "pages": [
    2162
   ]
  },
  {
   "title": "Gomella's Neonatology: Management, Procedures, On-Call Problems, Diseases, and Drugs, Eighth Edition",
   "author": "Tricia Lacy Gomella, Fabien G. Eyal and Fayez Bany-Mohammed",
   "pages": [
    1231
   ]
  },
  {
   "title": "Red Book Atlas 4th Ed.indb",
   "author": "American Academy of Pediatrics;Carol J. Baker, MD, FAAP;",
   "pages": [
    118
   ]
  },
  {
   "title": "Red_Book_2021_2024_Report_of_the_Comm_z_library_sk,_1lib_sk,",
   "author": null,
   "pages": [
    309
   ]
  },
  {
   "title": "2021_Fleisher_&_Ludwig's_Textbook_of_Pediatric_Emergency_Medicine.epub",
   "author": null,
   "pages": []
  },
  {
   "title": "The Harriet Lane Handbook (The Johns Hopkins Hospital)",
   "author": null,
   "pages": [
    148
   ]
  },
  {
   "title": "The Harriet Lane Handbook 22nd Edition (2020) (The Johns Hopkins Hospital)",
   "author": null,
   "pages": [
    148
   ]
  }
 ],
 "passages": [
  {
   "source": "Red Book 2018, p. 220",
   "text": "Trichomoniasis is transmitted perinatally or by sexual contact. In a perinatally infected infant, vaginal discharge can persist for several weeks; accordingly, intense social investigation may not be warranted. However, a new diagnosis of trichomoniasis in an older infant or prepubertal child should prompt a careful investigation, including a child protective services investigation, for suspected sexual abuse. It is important to note that _T vaginalis_ identified in the urine must be differentiated from _Trichomonas hominis_ , a nonpathogenic contaminant found in the gastrointestinal tract."
  },
  {
   "source": "Kliegman R. Nelson Textbook of Pediatrics 2-Volume Set 22ed 2024, p. 2162",
   "text": "Trichomoniasis is the most common parasitic infection in the United States, with a prevalence of 2.6 million cases and 6.9 million incident infections per year. Among the factors associated with a higher prevalence of infection are female sex, belonging to underrepresented minorities, poverty, lower educational attainment, younger age at first sex, multiple sexual partners, and a recent _Chlamydia_ infection. Vaginal trichomoniasis is rare until menarche, and its presence in a younger child should raise the possibility of **sexual abuse.** Trichomoniasis may be transmitted to neonates during passage through an infected birth canal. Infection in this setting is usually selflimited, but rare cases of neonatal vaginitis and respiratory infection have been reported. ## **PATHOGENESIS**"
  },
  {
   "source": "Gomella's Neonatology: Management, Procedures, On-Call Problems, Diseases, and Drugs, Eighth Edition, p. 1231",
   "text": "- **C. Clinical neonatal disease.** Those with evident clinical disease may have disseminated illness or isolated CNS or ocular disease. Late sequelae are primarily related to ocular or CNS disease. **Obstructive hydrocephalus, chorioretinitis, and diffuse intracranial calcifications** form the **classic triad of toxoplasmosis,** which is found in <10% of the cases. Beside the classic triad, other prominent features in symptomatic infants include abnormalities of CSF (high protein), anemia, seizures, direct hyperbilirubinemia, fever, hepatosplenomegaly, lymphadenopathy, eosinophilia, bleeding diathesis, hypothermia, rash, and pneumonitis. Some of these symptoms may develop in the first few months of life. **149:** TOxOPlASmOSIS 1199"
  },
  {
   "source": "Red Book Atlas 4th Ed.indb, p. 118",
   "text": "**107** ## CHAPTER 30 ## _Chlamydia trachomatis_ ## CLINICAL MANIFESTATIONS _Chlamydia trachomatis_ is associated with a range of clinical manifestations, including neonatal conjunctivitis, nasopharyngitis, and pneumonia in young infants as well as genital tract infection, lymphogranuloma venereum (LGV), and trachoma in children and adolescents. - **Neonatal chlamydial conjunctivitis** is characterized by ocular congestion, edema, and discharge developing a few days to several weeks after birth and lasting for 1 to 2 weeks and sometimes longer. In contrast to trachoma, scars and pannus formation are rare."
  },
  {
   "source": "Red Book Atlas 4th Ed.indb, p. 118",
   "text": "**107** ## CHAPTER 30 ## _Chlamydia trachomatis_ ## CLINICAL MANIFESTATIONS _Chlamydia trachomatis_ is associated with a range of clinical manifestations, including neonatal conjunctivitis, nasopharyngitis, and pneumonia in young infants as well as genital tract infection, lymphogranuloma venereum (LGV), and trachoma in children and adolescents. - **Neonatal chlamydial conjunctivitis** is characterized by ocular congestion, edema, and discharge developing a few days to several weeks after birth and lasting for 1 to 2 weeks and sometimes longer. In contrast to trachoma, scars and pannus formation are rare."
  },
  {
   "source": "Red_Book_2021_2024_Report_of_the_Comm_z_library_sk,_1lib_sk,, p. 309",
   "text": "## Chlamydia trachomatis **CLINICAL MANIFESTATIONS:** _Chlamydia trachomatis_ is associated with a range of clinical manifestations, including neonatal conjunctivitis, nasopharyngitis, and pneumonia in young infants as well as genital tract infection, lymphogranuloma venereum (LGV), and trachoma in children, adolescents, and adults. - **Neonatal chlamydial conjunctivitis** is characterized by ocular congestion, edema, and discharge developing a few days to several weeks after birth and lasting for 1 to 2 weeks and sometimes longer. In contrast to trachoma, scars and pannus formation (vascularization of the normally avascular cornea) are rare."
  },
  {
   "source": "2021_Fleisher_&_Ludwig's_Textbook_of_Pediatric_Emergency_Medicine.epub",
   "text": "TRICHOMONAL VAGINITIS Clinical Considerations Clinical Recognition A small proportion of vaginally delivered female neonates acquire trichomonal vaginitis from their infected mothers. Infants harboring only a few trichomonads may never develop clinical disease, but the remainder will have a thin whitish or yellowish vaginal discharge that appears within 10 days after birth and may persist for several months if untreated. Infected babies may be fussy but are otherwise well. The classic vaginal discharge of trichomonal vaginitis after puberty is pruritic, frothy, and yellowish. However, many infected women do not complain of excessive discharge and the discharge may be scant or nondescript. A \u201cstrawberry cervix\u201d with multiple punctate areas of hemorrhage is pathognomonic for trichomoniasis but is visible without colposcopy in only about 2% of infected patients. Clinical Assessment"
  },
  {
   "source": "The Harriet Lane Handbook (The Johns Hopkins Hospital), p. 148",
   "text": "**Chapter 5** Adolescent Medicine **113** to tolerate or follow outpatient oral regimen, failure to respond to appropriate outpatient therapy, or follow- up cannot be ensured. ## 5. **Trichomoniasis**[18] - a. Etiology: _Trichomonas vaginalis_ - b. Diagnosis and treatment: See Table 5.5. - c. Follow- up: Women treated for trichomoniasis should be retested 3 months after treatment due to high rates of reinfection. - d. Partner treatment: Partners should be treated to prevent reinfection. ## 6. **Mycoplasma genitalium**[18] - a. Etiology: _Mycoplasma genitalium_ - b. Clinical manifestations: Persistent urethritis, cervicitis, or PID despite appropriate treatment. - c. Diagnosis: No FDA- approved diagnostic test; NAAT is available in some large medical centers and commercial laboratories. - d. Treatment: Moxifloxacin has been used successfully; refer to latest CDC treatment guidelines. 7. **Vaginal infections, genital ulcers, and warts**"
  },
  {
   "source": "The Harriet Lane Handbook 22nd Edition (2020) (The Johns Hopkins Hospital), p. 148",
   "text": "**Chapter 5** Adolescent Medicine **113** to tolerate or follow outpatient oral regimen, failure to respond to appropriate outpatient therapy, or follow- up cannot be ensured. ## 5. **Trichomoniasis**[18] - a. Etiology: _Trichomonas vaginalis_ - b. Diagnosis and treatment: See Table 5.5. - c. Follow- up: Women treated for trichomoniasis should be retested 3 months after treatment due to high rates of reinfection. - d. Partner treatment: Partners should be treated to prevent reinfection. ## 6. **Mycoplasma genitalium**[18] - a. Etiology: _Mycoplasma genitalium_ - b. Clinical manifestations: Persistent urethritis, cervicitis, or PID despite appropriate treatment. - c. Diagnosis: No FDA- approved diagnostic test; NAAT is available in some large medical centers and commercial laboratories. - d. Treatment: Moxifloxacin has been used successfully; refer to latest CDC treatment guidelines. 7. **Vaginal infections, genital ulcers, and warts**"
  },
  {
   "source": "Red Book 2018, p. 1258",
   "text": "children, 169, 170t, 171t, 172 clinical manifestations, 820\u2013821 control measures, 823 diagnostic tests, 821\u2013822 epidemiology, 821 etiology, 821 isolation of the hospitalized patient, 823 prepubertal vaginitis, 936t sexual abuse, 170t, 171t treatment, 822\u2013823 urethritis/cervicitis, 933t, 936t vulvovaginitis, 933t Trichomoniasis, 358, 820\u2013823 _Trichophyton interdigitale,_ 805 _Trichophyton mentagrophytes,_ 802, 805 _Trichophyton rubrum,_ 802, 805 _Trichophyton_ species tinea capitis, 799\u2013801 tinea corporis, 802 _Trichophyton tonsurans_ school health, 142 tinea capitis, 799\u2013801 tinea corporis, 802 tinea cruris, 805 _Trichophyton verrucosum,_ 805 _Trichophyton violaceum,_ 799\u2013801 _Trichosporon_ species, 347t, 942t Trichotillomania, 798 Trichuriasis, 823\u2013824, 1019t clinical manifestations, 823 control measures, 824 diagnostic tests, 824 epidemiology, 824 etiology, 823\u2013824 internationally adopted, refugee, and immigrant children, 180 isolation of the hospitalized patient, 824 treatment, 824 _Trichuris trichiura,_"
  },
  {
   "source": "Kliegman R. Nelson Textbook of Pediatrics 2-Volume Set 22ed 2024, p. 2162",
   "text": "_Visit Elsevier eBooks+ at eBooks.Health.Elsevier.com for Bibliography._ ## Chapter 330 **Trichomoniasis (Trichomonas vaginalis)** _Edsel Maurice T. Salvana and Robert A. Salata_ Trichomoniasis is caused by the protozoan _Trichomonas vaginalis._ It is the second most common sexually transmitted infection worldwide. Vulvovaginitis is the symptomatic disease form, but _T. vaginalis_ has been implicated in pelvic inflammatory disease, pregnancy loss, chronic prostatitis, and an increased risk of HIV transmission. ## **EPIDEMIOLOGY** Over 156 million new cases of trichomoniasis occur annually around the world. Most men and up to 30% of women are asymptomatic. Although the disease is easily treated, sequelae of untreated infection remain a significant cause of morbidity because of high reinfection rates from untreated partners, underrecognition of asymptomatic cases, and insensitive diagnostics."
  },
  {
   "source": "Red Book 2018, p. 328",
   "text": "## Chlamydia trachomatis **CLINICAL MANIFESTATIONS:** _Chlamydia trachomatis_ is associated with a range of clinical > 1National Association of State Public Health Veterinarians. Compendium of measures to control _Chlamydia psittaci_ infection among humans (psittacosis) and pet birds (avian chlamydiosis). _J Avian Med Surg_ . 2017;31(3). Available at: **www.nasphv.org/Documents/PsittacosisCompendium.pdf** CHLAMYDIA TRACHOMATIS 277 manifestations, including neonatal conjunctivitis, nasopharyngitis, and pneumonia in young infants as well as genital tract infection, lymphogranuloma venereum (LGV), and trachoma in children and adolescents. - **Neonatal chlamydial conjunctivitis** is characterized by ocular congestion, edema, and discharge developing a few days to several weeks after birth and lasting for 1 to 2 weeks and sometimes longer. In contrast to trachoma, scars and pannus formation are rare."
  },
  {
   "source": "Red Book Atlas of Pediatric Infectious Diseases, p. 749",
   "text": "## **Neonatal** For newborns, infection with TV acquired maternally is self-limited, and treatment is not generally recommended. _TRICHOMONAS VAGINALIS_ INFECTIONS ![](/tmp/pdf-images/pdf-0749-01.png) ![](/tmp/pdf-images/pdf-0749-02.png) **Image 151.2** This patient presented with a strawberry cervix (colpitis macularis) caused by a _Trichomonas vaginalis_ infection, or trichomoniasis. The term _strawberry cervix_ is used to describe the appearance of the cervix caused by the presence of _T vaginalis_ protozoa. The cervical mucosa reveals punctate hemorrhages along with accompanying vesicles or papules. Courtesy of Centers for Disease Control and Prevention. **Image 151.1**"
  },
  {
   "source": "CURRENT Diagnosis and Treatment Pediatrics, Twenty-Fourth Edition, p. 1397",
   "text": "Donders G: Diagnosis and management of bacterial vaginosis and ~~other types of abnormal vaginal bacterial flora: a review. Obstet~~ Gynecol Surv 2010;65:462 [PMID: 20723268]. ## **2. Trichomoniasis** ## \u00bb **General Considerations** Trichomoniasis is caused by _T vaginalis_ , a flagellated protozoan that infects 3.7 million people annually in the United States. ## \u00bb **Clinical Findings** ## **A. Symptoms and Signs** Fifty percent of females with trichomoniasis develop a symptomatic vaginitis with vaginal itching, a green-gray malodorous frothy discharge, and dysuria. Occasionally postcoital bleeding and dyspareunia may be present. The vulva may be erythematous and the cervix friable. ## **B. Laboratory Findings** Mixing the discharge with normal saline facilitates detection of the flagellated protozoan on microscopic examination (wet preparation). This has a sensitivity of only 60%\u201370% even with **1365** **SEXUALLY TRANSMITTED INFECTIONS**"
  }
 ]
}