infectious diseases
Trichomoniasis
Diagnosis of Trichomoniasis
Vaginal testing with nucleic acid amplification tests (NAATs), wet-mount microscopic examination, rapid-antigen dipstick tests, or sometimes culture or cervical cytology Culture of urine or urethral swabs from men Trichomoniasis should be suspected in women with vaginitis, in men with urethritis, and in their sex partners. Suspicion is high if symptoms persist after patients have been evaluated and treated for other infections such as Gonorrhea and In women, one of the following diagnostic tests of vaginal secretions may be done: NAAT Vaginal pH and wet mount microscopy Immunochromatographic flow dipstick test NAATsare more sensitive than microscopic examination or culture for diagnosis of trichomoniasis in women. Immunochromatographic flow dipstick tests are also available for point of care testing in women. Cervical cytology (Pap test) is not used to test for trichomoniasis, but infection is sometimes detected incidentally. enables clinicians to evaluate for trichomoniasis and Bacterial Vaginosis (BV) at the same time, because they cause similar symptoms and/or may coexist. Vaginal secretions are obtained from the posterior fornix. The pH is measured. Secretions are then placed on 2 slides; they are diluted with 10% potassium hydroxide on one slide (KOH wet mount) and with 0.9% Culture of urine or urethral swabsis the only validated test for detectingT. vaginalisin men. In men, microscopy of urine is insensitive, and NAATs are not currently cleared by the FDA but could be available if local laboratories have done internal validation studies. As with diagnosis of any STI, patients with trichomoniasis should be tested to exclude other common STIs such as gonorrhea and chlamydia. 