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An Itchy Twitchy Friend That Lives Within…

An Itchy Twitchy Friend That Lives Within…. Group 5 Case Study 3 Kellie Knabe, Jill Odom, Shelley Simpson.

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An Itchy Twitchy Friend That Lives Within…

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  1. An Itchy Twitchy Friend That Lives Within… Group 5 Case Study 3 Kellie Knabe, Jill Odom, Shelley Simpson

  2. A 24-year-old woman is referred to a public health clinic as a result of contact tracing from a case of gonorrhea. She recently had unprotected sex with her infected male partner but showed no symptoms. A pelvic examination recovers a greenish discharge containing protozoa with a characteristic “jerky” motility. The women tested negative for gonorrhea.

  3. Differential Diagnosis and Causes • Differential Diagnosis: Trichomoniasis • Possible Causes: Multiple sex partners, having unprotected sex, wet linens

  4. AMS microblibrary.org

  5. Probable Etiological Agents • Trichomonas vaginalis • Neisseria gonorrhea • Chlamydia trachomatis • Gardnerella vaginalis • Candida albicans (yeast infection) • Foreign bodies (tampons, IUD’s, condoms)

  6. Further Information Needed for Diagnosis • Thorough patient history including sexual history • Physical examination • Serology • Urinalysis • CBC • HIV test

  7. Most Likely Etiological Agent • Single-celled protozoan Trichomonas vaginalis, which was obtained by a wet mount showing a protozoa with a jerky motility

  8. What is Wrong With Patient? • Trichomoniasis infection • Most common curable STD in young, sexually active women • 7.4 cases occur each year

  9. Symptoms in Men • Typically asymptomatic, but if symptoms do appear: • Discharge from urethra • Urge to urinate • Burning sensation after urinating or ejaculation

  10. Symptoms in Women • Frothy green discharge with fishy smell from the vagina • Vaginal itching and irritation • Painful sexual intercourse • Lower abdominal pain • Burning sensation after urinating

  11. Suggested Treatment • Single dose 2 gm Metronidazole or 500 mg Metronidazole PO bid for seven days • If resistant to Metronidazole: • Single dose 2 gm Tinidazole • Treat male partner with single dose 2 gm Metronidazole • Avoid sexual intercourse until treatment is completed • Practice safe sex

  12. Works Cited • Gilbert, M.D., David, et al. The Sanford Guide to Antimicrobial Therapy 2006. 36th ed. Sperryville: Antimicrobial Therapy, Inc., 2006. • “Sexually Transmitted Infections: Trichomoniasis”. Sexuality and U. 5 September 2006. 16 October 2006 http://www.sexualityandu.ca/teens/sti-1-7.aspx.

  13. Works Cited • “Trichomonas Infection”. Center for Disease Control and Prevention. 9 September 2004. 17 October 2006. http://www.cdc.gov/nicdod/dpd/parasites/trichomonas/2004_PDF_trichomonas.pdf. • “Trichomonas”. Center for Disease Control. May 2004. 18 October 2006. http://www.cdc.gov/std/trichomonas/STDFact-Trichomonas.htm.

  14. Works Cited • “Trichomonas vaginalis”. Center for Disease Control and Prevention. 2 May 2002. 18 October 2006. http://www.dpd.cdc.gov/DPDx/HTML/ImageLibrary/Trichomonas.

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