Pediatric Trichomoniasis Treatment & Management

  • Author: Robert W Tolan Jr, MD; Chief Editor: Russell W Steele, MD   more...
 
Updated: Jan 10, 2012
 

Medical Care

Evaluation for trichomoniasis is normally conducted in the outpatient setting. Inpatient therapy may be indicated when resistance is present and intravenous therapy is indicated.

Next

Consultations

Consult with an infectious diseases specialist or experts from the Centers for Disease Control and Prevention (CDC) for patients who have a positive culture for T vaginalis that is resistant to regimens described below and in whom reinfection has been excluded.

Previous
Next

Activity

Modifying sexual behavior helps reduce incidence of infection. Consistent use of condoms and other barrier contraceptives also reduces the chance of infection.

Previous
Proceed to Medication
 
 
Contributor Information and Disclosures
Author

Robert W Tolan Jr, MD  Chief, Division of Allergy, Immunology and Infectious Diseases, The Children's Hospital at Saint Peter's University Hospital; Clinical Associate Professor of Pediatrics, Drexel University College of Medicine

Robert W Tolan Jr, MD is a member of the following medical societies: American Academy of Pediatrics, American Medical Association, American Society for Microbiology, American Society of Tropical Medicine and Hygiene, Infectious Diseases Society of America, Pediatric Infectious Diseases Society, Phi Beta Kappa, and Physicians for Social Responsibility

Disclosure: Novartis Honoraria Speaking and teaching

Specialty Editor Board

Ashir Kumar, MD, MBBS, FAAP  Professor Emeritus, Department of Pediatrics and Human Development, Michigan State University College of Human Medicine

Ashir Kumar, MD, MBBS, FAAP is a member of the following medical societies: American Association of Physicians of Indian Origin and Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Mary L Windle, PharmD  Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Martin Weisse, MD  Program Director, Associate Professor, Department of Pediatrics, West Virginia University

Martin Weisse, MD is a member of the following medical societies: Ambulatory Pediatric Association, American Academy of Pediatrics, and Pediatric Infectious Diseases Society

Disclosure: Nothing to disclose.

Daniel Rauch, MD, FAAP  Director, Pediatric Hospitalist Program, Associate Professor, Department of Pediatrics, New York University School of Medicine

Daniel Rauch, MD, FAAP is a member of the following medical societies: Ambulatory Pediatric Association, American Academy of Pediatrics, and Society of Hospital Medicine

Disclosure: Baxter Honoraria Consulting

Chief Editor

Russell W Steele, MD  Head, Division of Pediatric Infectious Diseases, Ochsner Children's Health Center; Clinical Professor, Department of Pediatrics, Tulane University School of Medicine

Russell W Steele, MD is a member of the following medical societies: American Academy of Pediatrics, American Association of Immunologists, American Pediatric Society, American Society for Microbiology, Infectious Diseases Society of America, Louisiana State Medical Society, Pediatric Infectious Diseases Society, Society for Pediatric Research, and Southern Medical Association

Disclosure: Nothing to disclose.

Additional Contributors

The authors and editors of Medscape Reference gratefully acknowledge the contributions of previous authors Renee Wilson, MD and Binita R Shah, MD, FAAP to the development and writing of this article.

References

  1. Bachmann LH, Hobbs MM, Seña AC, Sobel JD, Schwebke JR, Krieger JN. Trichomonas vaginalis Genital Infections: Progress and Challenges. Clin Infect Dis. Dec 2011;53 Suppl 3:S160-72. [Medline].

  2. Goyal M, Hayes K, McGowan KL, Fein JA, Mollen C. Prevalence of Trichomonas vaginalis infection in symptomatic adolescent females presenting to a pediatric emergency department. Acad Emerg Med. Jul 2011;18(7):763-6. [Medline].

  3. Wolner-Hanssen P, Krieger JN, Stevens CE, et al. Clinical manifestations of vaginal trichomoniasis. JAMA. Jan 27 1989;261(4):571-6. [Medline].

  4. Ahrens KR, Richardson LP, Courtney ME, McCarty C, Simoni J, Katon W. Laboratory-Diagnosed Sexually Transmitted Infections in Former Foster Youth Compared With Peers. Pediatrics. Jun 14 2010;[Medline].

  5. Dopkins Broecker JE, Huppert JS. Trichomoniasis in adolescents: routine screening is advised for your patients at risk. Contemp Pediatr. Sept 2011;28-46.

  6. Huppert JS, Hesse EA, Bernard MA, Xiao Y, Huang B, Gaydos CA, et al. Acceptability of self-testing for trichomoniasis increases with experience. Sex Transm Infect. Oct 2011;87(6):494-500. [Medline]. [Full Text].

  7. Bell C, Hough E, Smith A, Greene L. Targeted screening for Trichomonas vaginalis in women, a pH-based approach. Int J STD AIDS. Jun 2007;18(6):402-3. [Medline].

  8. Huppert JS, Mortensen JE, Reed JL, et al. Rapid antigen testing compares favorably with transcription-mediated amplification assay for the detection of Trichomonas vaginalis in young women. Clin Infect Dis. 2007;45:194-8. [Medline].

  9. Diaz N, Dessì D, Dessole S, Fiori PL, Rappelli P. Rapid detection of coinfections by Trichomonas vaginalis, Mycoplasma hominis, and Ureaplasma urealyticum by a new multiplex polymerase chain reaction. Diagn Microbiol Infect Dis. May 2010;67(1):30-6. [Medline].

  10. Simpson P, Higgins G, Qiao M, Waddell R, Kok T. Real-time PCRs for detection of Trichomonas vaginalis beta-tubulin and 18S rRNA genes in female genital specimens. J Med Microbiol. Jun 2007;56(Pt 6):772-7. [Medline].

  11. Andrea SB, Chapin KC. Comparison of Aptima Trichomonas vaginalis transcription-mediated amplification assay and BD affirm VPIII for detection of T. vaginalis in symptomatic women: performance parameters and epidemiological implications. J Clin Microbiol. Mar 2011;49(3):866-9. [Medline]. [Full Text].

  12. Cudmore SL, Delgaty KL, Hayward-McClelland SF, Petrin DP, Garber GE. Treatment of infections caused by metronidazole-resistant Trichomonas vaginalis. Clin Microbiol Rev. Oct 2004;17(4):783-93, table of contents. [Medline].

  13. Mammen-Tobin A, Wilson JD. Management of metronidazole-resistant Trichomonas vaginalis--a new approach. Int J STD AIDS. Jul 2005;16(7):488-90. [Medline].

  14. Zalonis CA, Pillay A, Secor W, Humburg B, Aber R. Rare case of trichomonal peritonitis. Emerg Infect Dis. Jul 2011;17(7):1312-3. [Medline].

  15. Trintis J, Epie N, Boss R, Riedel S. Neonatal Trichomonas vaginalis infection: a case report and review of literature. Int J STD AIDS. Aug 2010;21(8):606-7. [Medline].

  16. CDC. 1998 guidelines for treatment of sexually transmitted diseases. MMWR Recomm Rep. Jan 23 1998;47(RR-1):1-111. [Medline].

  17. AAP. Trichomonas vaginalis infections (Trichomoniasis). In: Red Book: 2009 Report of the Committee on Infectious Diseases. 28th. Elk Grove Village, IL: American Academy of Pediatrics; 2009:674-5.

  18. Annang L, Walsemann KM, Maitra D, Kerr JC. Does education matter? Examining racial differences in the association between education and STI diagnosis among black and white young adult females in the U.S. Public Health Rep. Jul-Aug 2010;125 Suppl 4:110-21. [Medline]. [Full Text].

  19. Berlan ED, Holland-Hall C. Sexually transmitted infections in adolescents: advances in epidemiology, screening, and diagnosis. Adolesc Med State Art Rev. Aug 2010;21(2):332-46, x. [Medline].

  20. Brotman RM, Erbelding EJ, Jamshidi RM, Klebanoff MA, Zenilman JM, Ghanem KG. Findings associated with recurrence of bacterial vaginosis among adolescents attending sexually transmitted diseases clinics. J Pediatr Adolesc Gynecol. Aug 2007;20(4):225-31. [Medline].

  21. Carlton JM, Hirt RP, Silva JC, et al. Draft genome sequence of the sexually transmitted pathogen Trichomonas vaginalis. Science. Jan 12 2007;315(5809):207-12. [Medline].

  22. Carter JE, Whithaus KC. Neonatal respiratory tract involvement by Trichomonas vaginalis: a case report and review of the literature. Am J Trop Med Hyg. Jan 2008;78(1):17-9. [Medline].

  23. Cobo ER, Eckmann L, Corbeil LB. Murine models of vaginal trichomonad infections. Am J Trop Med Hyg. Oct 2011;85(4):667-73. [Medline].

  24. Cornelius DC, Mena L, Lushbaugh WB, Meade JC. Genetic Relatedness of Trichomonas vaginalis Reference and Clinical Isolates. Am J Trop Med Hyg. Dec 2010;83(6):1283-6. [Medline].

  25. Crosby RA, DiClemente RJ, Wingood GM, Rose E, Levine D. Adjudication history and African American adolescents' risk for acquiring sexually transmitted diseases: an exploratory analysis. Sex Transm Dis. Aug 2003;30(8):634-8. [Medline].

  26. DeMeo LR, Draper DL, McGregor JA, et al. Evaluation of a deoxyribonucleic acid probe for the detection of Trichomonas vaginalis in vaginal secretions. Am J Obstet Gynecol. Apr 1996;174(4):1339-42. [Medline].

  27. Garcia AF, Alderete J. Characterization of the Trichomonas vaginalis surface-associated AP65 and binding domain interacting with trichomonads and host cells. BMC Microbiol. Dec 25 2007;7:116. [Medline].

  28. Gaydos CA, Hsieh YH, Galbraith JS, Barnes M, Waterfield G, Stanton B. Focus-on-Teens, sexual risk-reduction intervention for high-school adolescents: impact on knowledge, change of risk-behaviours, and prevalence of sexually transmitted diseases. Int J STD AIDS. Oct 2008;19(10):704-10. [Medline].

  29. Gaydos CA, Quinn TC. Urine nucleic acid amplification tests for the diagnosis of sexually transmitted infections in clinical practice. Curr Opin Infect Dis. Feb 2005;18(1):55-66. [Medline].

  30. Glasier A, Gulmezoglu AM, Schmid GP, et al. Sexual and reproductive health: a matter of life and death. Lancet. Nov 4 2006;368(9547):1595-607. [Medline].

  31. Hammerschlag MR, Guillen CD. Medical and legal implications of testing for sexually transmitted infections in children. Clin Microbiol Rev. Jul 2010;23(3):493-506. [Medline]. [Full Text].

  32. Hammill HA. Trichomonas vaginalis. Obstet Gynecol Clin North Am. Sep 1989;16(3):531-40. [Medline].

  33. Ingersoll J, Bythwood T, Abdul-Ali D, Wingood GM, Diclemente RJ, Caliendo AM. Stability of Trichomonas vaginalis DNA in urine specimens. J Clin Microbiol. May 2008;46(5):1628-30. [Medline].

  34. Jirovec O, Petru M. Trichomonas vaginalis and trichomoniasis. Adv Parasitol. 1968;6:117-88. [Medline].

  35. Johnston VJ, Mabey DC. Global epidemiology and control of Trichomonas vaginalis. Curr Opin Infect Dis. Feb 2008;21(1):56-64. [Medline].

  36. Khan MR, Kaufman JS, Pence BW, Gaynes BN, Adimora AA, Weir SS, et al. Depression, sexually transmitted infection, and sexual risk behavior among young adults in the United States. Arch Pediatr Adolesc Med. Jul 2009;163(7):644-52. [Medline].

  37. Krashin JW, Koumans EH, Bradshaw-Sydnor AC, et al. Trichomonas vaginalis prevalence, incidence, risk factors and antibiotic-resistance in an adolescent population. Sex Transm Dis. Jul 2010;37(7):440-4. [Medline].

  38. Krieger JN, Tam MR, Stevens CE, et al. Diagnosis of trichomoniasis. Comparison of conventional wet-mount examination with cytologic studies, cultures, and monoclonal antibody staining of direct specimens. JAMA. Feb 26 1988;259(8):1223-7. [Medline].

  39. Laga M, Manoka A, Kivuvu M, et al. Non-ulcerative sexually transmitted diseases as risk factors for HIV-1 transmission in women: results from a cohort study. AIDS. Jan 1993;7(1):95-102. [Medline].

  40. Lossick JG, Kent HL. Trichomoniasis: trends in diagnosis and management. Am J Obstet Gynecol. Oct 1991;165(4 Pt 2):1217-22. [Medline].

  41. Mabey D, Ackers J, Adu-Sarkodie Y. Trichomonas vaginalis infection. Sex Transm Infect. Dec 2006;82 Suppl 4:iv26-7. [Medline].

  42. McClelland RS. Trichomonas vaginalis infection: can we afford to do nothing?. J Infect Dis. Feb 15 2008;197(4):487-9. [Medline].

  43. Miller WC, Zenilman JM. Epidemiology of chlamydial infection, gonorrhea, and trichomoniasis in the United States--2005. Infect Dis Clin North Am. Jun 2005;19(2):281-96. [Medline].

  44. Mulcahy FM, Lacey CJ. Sexually transmitted infections in adolescent girls. Genitourin Med. Apr 1987;63(2):119-21. [Medline].

  45. Nyirjesy P. Vaginitis in the adolescent patient. Pediatr Clin North Am. Aug 1999;46(4):733-45, xi. [Medline].

  46. Okun N, Gronau KA, Hannah ME. Antibiotics for bacterial vaginosis or Trichomonas vaginalis in pregnancy: a systematic review. Obstet Gynecol. Apr 2005;105(4):857-68. [Medline].

  47. Owusu-Edusei K Jr, Tejani MN, Gift TL, Kent CK, Tao G. Estimates of the direct cost per case and overall burden of trichomoniasis for the employer-sponsored privately insured women population in the United States, 2001 to 2005. Sex Transm Dis. Jun 2009;36(6):395-9. [Medline].

  48. Pattullo L, Griffeth S, Ding L, Mortensen J, Reed J, Kahn J, et al. Stepwise diagnosis of Trichomonas vaginalis infection in adolescent women. J Clin Microbiol. Jan 2009;47(1):59-63. [Medline].

  49. Pelosini I, Scarpignato C. Rifaximin, a peculiar rifamycin derivative: established and potential clinical use outside the gastrointestinal tract. Chemotherapy. 2005;51 Suppl 1:122-30. [Medline].

  50. Petrin D, Delgaty K, Bhatt R, Garber G. Clinical and microbiological aspects of Trichomonas vaginalis. Clin Microbiol Rev. Apr 1998;11(2):300-17. [Medline]. [Full Text].

  51. Physicians Desk Reference. 5th ed. New Jersey: Medical Economics Company; 2000.

  52. Reed JL, Simendinger L, Griffeth S, Kim HG, Huppert JS. Point-of-care testing for sexually transmitted infections increases awareness and short-term abstinence in adolescent women. J Adolesc Health. Mar 2010;46(3):270-7. [Medline]. [Full Text].

  53. Risser WL, Bortot AT, Benjamins LJ, et al. The epidemiology of sexually transmitted infections in adolescents. Semin Pediatr Infect Dis. Jul 2005;16(3):160-7. [Medline].

  54. Romoren M, Velauthapillai M, Rahman M, Sundby J, Klouman E, Hjortdahl P. Trichomoniasis and bacterial vaginosis in pregnancy: inadequately managed with the syndromic approach. Bull World Health Organ. Apr 2007;85(4):297-304. [Medline].

  55. Say PJ, Jacyntho C. Difficult-to-manage vaginitis. Clin Obstet Gynecol. Dec 2005;48(4):753-68. [Medline].

  56. Schwebke JR, Burgess D. Trichomoniasis. Clin Microbiol Rev. Oct 2004;17(4):794-803, table of contents. [Medline]. [Full Text].

  57. Sena AC, Miller WC, Hobbs MM, et al. Trichomonas vaginalis infection in male sexual partners: implications for diagnosis, treatment, and prevention. Clin Infect Dis. Jan 1 2007;44(1):13-22. [Medline].

  58. [Best Evidence] [Guideline] Sexually transmitted diseases treatment guidelines, 2010. MMWR Recomm Rep. Dec 17 2010;59:1-110. [Medline].

  59. Shafir SC, Sorvillo FJ, Smith L. Current issues and considerations regarding trichomoniasis and human immunodeficiency virus in African-Americans. Clin Microbiol Rev. Jan 2009;22(1):37-45, Table of Contents. [Medline]. [Full Text].

  60. Sobel JD. Vaginitis. N Engl J Med. Dec 25 1997;337(26):1896-903. [Medline].

  61. Sobel JD. Vulvovaginitis in healthy women. Compr Ther. Jun-Jul 1999;25(6-7):335-46. [Medline].

  62. Sobel JD. What's new in bacterial vaginosis and trichomoniasis?. Infect Dis Clin North Am. Jun 2005;19(2):387-406. [Medline].

  63. Sobel JD, Nagappan V, Nyirjesy P. Metronidazole-resistant vaginal trichomoniasis--an emerging problem. N Engl J Med. Jul 22 1999;341(4):292-3. [Medline].

  64. Sobngwi-Tambekou J, Taljaard D, Nieuwoudt M, Lissouba P, Puren A, Auvert B. Male circumcision and Neisseria gonorrhoeae, Chlamydia trachomatis and Trichomonas vaginalis: observations after a randomised controlled trial for HIV prevention. Sex Transm Infect. Apr 2009;85(2):116-20. [Medline].

  65. Sutton M, Sternberg M, Koumans EH, McQuillan G, Berman S, Markowitz L. The prevalence of Trichomonas vaginalis infection among reproductive-age women in the United States, 2001-2004. Clin Infect Dis. Nov 15 2007;45(10):1319-26. [Medline].

  66. Syed TS, Braverman PK. Vaginitis in adolescents. Adolesc Med Clin. Jun 2004;15(2):235-51. [Medline].

  67. Tibaldi C, Cappello N, Latino MA, Masuelli G, Marini S, Benedetto C. Vaginal and endocervical microorganisms in symptomatic and asymptomatic non-pregnant females: risk factors and rates of occurrence. Clin Microbiol Infect. Jul 2009;15(7):670-9. [Medline].

  68. Torok MR, Miller WC, Hobbs MM, Macdonald PD, Leone PA, Schwebke JR. The association between Trichomonas vaginalis infection and level of vaginal lactobacilli, in nonpregnant women. J Infect Dis. Oct 1 2007;196(7):1102-7. [Medline].

  69. Torok MR, Miller WC, Hobbs MM, Macdonald PD, Leone PA, Schwebke JR, et al. The association between oral contraceptives, depot-medroxyprogesterone acetate, and trichomoniasis. Sex Transm Dis. Jun 2009;36(6):336-40. [Medline].

  70. Tu W, Batteiger BE, Wiehe S, et al. Time from first intercourse to first sexually transmitted infection diagnosis among adolescent women. Arch Pediatr Adolesc Med. Dec 2009;163(12):1106-11. [Medline].

  71. Van der Pol B. Trichomonas vaginalis infection: the most prevalent nonviral sexually transmitted infection receives the least public health attention. Clin Infect Dis. Jan 1 2007;44(1):23-5. [Medline].

  72. Wendel KA, Workowski KA. Trichomoniasis: challenges to appropriate management. Clin Infect Dis. Apr 1 2007;44 Suppl 3:S123-9. [Medline].

  73. Wolner-Hanssen P. Trichomonas vaginalis. In: Akuffo H, Linder E, Ljungstrom I, Wahlgren M. Parasites of the Colder Climates. London and New York: Taylor & Francis; 2003:156-160.

  74. Workowski KA, Berman SM. Sexually transmitted diseases treatment guidelines, 2006. MMWR Recomm Rep. Aug 4 2006;55(RR-11):1-94. [Medline].

  75. Yule A, Gellan MC, Oriel JD, Ackers JP. Detection of Trichomonas vaginalis antigen in women by enzyme immunoassay. J Clin Pathol. May 1987;40(5):566-8. [Medline]. [Full Text].

 
Previous
Next
 
 
 
 
All material on this website is protected by copyright, Copyright © 1994-2012 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.

DISCLAIMER: The content of this Website is not influenced by sponsors. The site is designed primarily for use by qualified physicians and other medical professionals. The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a physician if you suspect you are ill.