bubble_chart Overview

Trichomonal vulvitis is often secondary to trichomonal vaginitis. In women, Trichomonas vaginalis is commonly found in the vagina, urethra, Bartholin's glands, and bladder. Involvement of the Bartholin's glands is rare. Trichomonas vaginalis is a flagellated protozoan, much larger than polymorphonuclear leukocytes, pear-shaped with four flagella at the anterior end and an axostyle protruding from the posterior end. It can reside in the human body without causing clinical symptoms. Certain bacteria may stimulate the activity of trichomonads, leading to symptoms. However, the infection can also be transmitted directly or indirectly. Indirect transmission primarily occurs through public baths, bathing facilities, swimming pools, or inadequately sterilized medical equipment. Direct transmission can occur through sexual intercourse, originating from the male urinary system, and the patient's urine or feces may also serve as sources of infection.

bubble_chart Etiology

Trichomonas vaginalis is commonly found in the vagina, urethra, Bartholin's glands, and bladder, though involvement of the Bartholin's glands is rare. Trichomonas vaginalis is a type of flagellate, significantly larger than polymorphonuclear leukocytes, pear-shaped with four flagella at the anterior end and an axostyle protruding from the posterior. It can reside in the human body without causing clinical symptoms. Certain bacteria may activate the parasite, leading to symptoms, but antibodies in the body can suppress it. Transmission can occur directly or indirectly, primarily through public baths, swimming pools, improperly sterilized medical equipment, or sexual contact from the male urinary system. The urine and feces of infected individuals may also serve as sources of transmission.

bubble_chart Clinical Manifestations

The incubation period is 4 to 28 days, with small red granules or petechiae on the vaginal mucosa. The pH value is higher than normal. There is a large amount of yellow-green or gray foamy discharge from the vagina, with a foul odor, sometimes mixed with a small amount of blood or pus. The discharge irritates the vulva, causing itching. The vulva becomes red and may even develop inflammatory ulcers, some caused by moisture and abrasions, which can spread to the genitofemoral folds. Pain occurs during intercourse, and symptoms such as dysuria and frequent urination may also be present.

bubble_chart Diagnosis

The diagnosis can be easily made based on symptoms and signs, but confirmation requires the detection of Trichomonas vaginalis. Vaginal secretions are examined using the hanging drop method, where motile trichomonads can be observed under a microscope and may also be seen in stained smears. Culture may be performed if necessary. Since trichomoniasis affects vaginal cells, it is important to differentiate it from malignant tumors. If needed, a vaginal cytology examination can be conducted after treatment.

bubble_chart Treatment Measures

Take oral metronidazole 200mg, three times a day for 7 to 10 days. The side effects are minor, with个别 cases experiencing nausea, diarrhea, vertigo, headache, rash, and granulocyte reduction after taking the medication. These side effects disappear after discontinuing the drug.

Locally, use a 1% lactic acid or vinegar solution to wash the vulva and douche the vagina; then, insert carbarsone, acetarsol, or trichomycin into the vagina for 7 to 10 days as one course of treatment.

Apply external Chinese medicinal lotion; decoct 30g of Carpesium Fruit, 15g each of Sophora, Fischer Euphorbia Root, Cnidium Fruit, Tail of Chinese Angelica, and Clematis Root in water for fumigation and sitz baths. During treatment, maintain local cleanliness and boil underwear and utensils in contact with the vulva for disinfection to prevent reinfection.