Swygard H, Seña A C, Hobbs M M, Cohen M S
The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7030, USA.
Sex Transm Infect. 2004 Apr;80(2):91-5. doi: 10.1136/sti.2003.005124.
Trichomonas vaginalis was originally considered a commensal organism until the 1950s when the understanding of its role as a sexually transmitted infection (STI) began to evolve. Trichomoniasis has been associated with vaginitis, cervicitis, urethritis, pelvic inflammatory disease (PID), and adverse birth outcomes. Infection with T vaginalis could have an important role in transmission and acquisition of HIV. T vaginalis is site specific for the genitourinary tract and has been isolated from virtually all genitourinary structures. Asymptomatic disease is common in both men and women, thus screening for disease is important. Various sociodemographic factors have been correlated with presence of T vaginalis, and may be used to predict infection. Diagnosis is usually made from wet mount microscopy and direct visualisation, which are insensitive. DNA amplification techniques perform with good sensitivity, but are not yet approved for diagnostic purposes. In areas where diagnostic methods are limited, management of trichomoniasis is usually as part of a clinical syndrome; vaginal discharge for women and urethral discharge for men. A single dose of metronidazole is effective in the majority of cases. Outside of the United States, other nitroimidazoles may be used and are as effective as metronidazole. Metronidazole resistance is an emerging problem, but its clinical importance is not yet clear. Concomitant treatment of sexual partners is recommended.
阴道毛滴虫最初被认为是一种共生生物，直到20世纪50年代，人们对其作为性传播感染（STI）的作用的认识才开始演变。滴虫病与阴道炎、宫颈炎、尿道炎、盆腔炎（PID）以及不良分娩结局有关。阴道毛滴虫感染在HIV的传播和感染中可能起重要作用。阴道毛滴虫在泌尿生殖道有特定的寄生部位，几乎可从所有泌尿生殖结构中分离出来。无症状感染在男性和女性中都很常见，因此疾病筛查很重要。各种社会人口统计学因素与阴道毛滴虫的存在相关，可用于预测感染。诊断通常通过湿片显微镜检查和直接观察进行，但这些方法不够敏感。DNA扩增技术的敏感性良好，但尚未被批准用于诊断目的。在诊断方法有限的地区，滴虫病的管理通常作为临床综合征的一部分；女性为白带异常，男性为尿道分泌物异常。大多数情况下，单剂量甲硝唑有效。在美国以外的地区，可使用其他硝基咪唑类药物，其效果与甲硝唑相同。甲硝唑耐药是一个新出现的问题，但其临床重要性尚不清楚。建议对性伴侣进行同步治疗。
