Trichomoniasis is a sexually transmitted infection that is characterized by increasing the risk of contracting other sexually transmitted diseases such as chlamydial infection, gonorrhea, HIV and is associated with cervical carcinogenesis. Another characteristic of trichomoniasis is that it increases the risk of postpartum and postoperative complications and infertility. In women, infection with Trichomonas vaginalis causes symptomatic vaginitis, while in men it is characteristically asymptomatic, which facilitates transmission and its easy spread. Trichomoniasis is a sexually transmitted disease, the main causative agent of which is the unicellular protozoan Trichomonas vaginalis. Trichomonas are the size of white blood cells and have whips (flagella), with the help of which they move. Transmission of trichomoniasis is exclusively sexual, transfer is very rare when using shared toiletries and very poor hygiene. The parasite can also be passed to the fetus at birth, where it can cause vaginitis, urethritis or respiratory infections. T. vaginalis can be found in the vagina, cervix, large vestibular (Bartholin’s) glands, and paraurethral (Skenian’s) glands in women. Its presence in the vagina leads to alkalinization of the environment and a pH above 4.5, which increases the risk of developing other sexually transmitted diseases. In the external environment, trichomonas are extremely unstable – they are destroyed at very high or low temperatures, under the influence of the sun’s rays, in an acidic environment. The risk of infection with T.vaginalis increases in patients with multiple sexual partners, frequent change of sexual partners, sexual contacts with an infected partner, previous or current sexually transmitted infection, failure to use condoms during intercourse, use of intravenous drugs. From a pathophysiological point of view, the parasite penetrates the epithelial cells of the mucous membranes of the genital tract and releases cytotoxic substances. By binding to host plasma proteins, it avoids recognition by the alternative complement pathway. The production of polymorphonuclear leukocytes is increased as a result of the production of chemotactic cytokines by the parasite. Symptomatically, trichomoniasis manifests itself after an incubation period of 4-28 days. Infection in women can occur in three forms: acute, chronic and asymptomatic. Characteristic of the acute form is that it occurs with the appearance of yellow-green, foamy vaginal discharge, which has an unpleasant odor. Patients complain of pain and burning during urination, pain during sexual contact, redness and itching in the vulva area, pelvic pain, etc. Bleeding after intercourse is possible. The infection manifests itself most often in the form of macular colpitis – so named because of the observation of a characteristic, “strawberry”, macular rash when viewed with a colposcope. In addition to colpitis, trichomoniasis can also manifest as cervicitis, which is characterized by purulent discharge in the endocervical canal and endocervical bleeding.In the chronic form, the symptoms are less pronounced and the macular colpitis is more widespread. The diagnosis of trichomoniasis is based on the clinical picture, microbiological examination and colposcopy. Macular colpitis is a specific symptom that is visualized during colposcopy and application of Lugol’s solution. When measuring the pH, an alkaline reaction of the environment in the vagina is established. A positive amine test when applying 10% KOH is also characteristic of trichomoniasis – release of an unpleasant odor after application of 10% KOH on vaginal discharge. A secretion is taken for cultural examination. PCR tests for trichomoniasis have great specificity. In terms of differential diagnosis, trichomoniasis can be confused with other sexually transmitted diseases, pelvic inflammatory disease, urethritis, vaginitis, etc. Complications that can occur as a result of T.vaginalis infection are sterility, postoperative complications, cervical intraepithelial neoplasia, etc. During pregnancy, trichomoniasis can lead to the birth of a low-weight fetus, premature birth, premature rupture of the amniotic sac, respiratory infections of the fetus. Trichomoniasis is a completely curable infection. The treatment is mainly systemic, but a combination with local therapy and vaccination is possible. A single dose of metronidazole of 2 g, a single dose of tinidazole of 2 g, or a 7-day course with metronidazole of 500 mg, twice a day, is administered systemically. Metronidazole and tinidazole work by reducing the 5-nitro group of anaerobic microorganisms. Systemic therapy can be combined with local application of the specified medications. There is also a vaccine for T.vaginalis – Solco-Trichovac, which is lyophilized inactivated strains. It is applied 3 times, 1 ampoule in 2 weeks. Treatment should be carried out in all partners who had contact with the infected person. During therapy, sexual contact is prohibited. Sources: Gynecology under the editorship of Prof. Dr. Angel Dimitrov, MD, PhD. and Prof. Dr. Viktor Zlatkov, MD, 2017 https://emedicine.medscape.com/article/230617-treatment https://www.ncbi.nlm.nih.gov/books/NBK534826/that can occur as a result of T.vaginalis infection are sterility, postoperative complications, cervical intraepithelial neoplasia, etc. During pregnancy, trichomoniasis can lead to the birth of a low-weight fetus, premature birth, premature rupture of the amniotic sac, respiratory infections of the fetus. Trichomoniasis is a completely curable infection. The treatment is mainly systemic, but a combination with local therapy and vaccination is possible. A single dose of metronidazole of 2 g, a single dose of tinidazole of 2 g, or a 7-day course with metronidazole of 500 mg, twice a day, is administered systemically. Metronidazole and tinidazole work by reducing the 5-nitro group of anaerobic microorganisms. Systemic therapy can be combined with local application of the specified medications. There is also a vaccine for T.vaginalis – Solco-Trichovac, which is lyophilized inactivated strains. It is applied 3 times, 1 ampoule in 2 weeks. Treatment should be carried out in all partners who had contact with the infected person. During therapy, sexual contact is prohibited. Sources: Gynecology under the editorship of Prof. Dr. Angel Dimitrov, MD, PhD. and Prof. Dr. Viktor Zlatkov, MD, 2017 https://emedicine.medscape.com/article/230617-treatment https://www.ncbi.nlm.nih.gov/books/NBK534826/that can occur as a result of T.vaginalis infection are sterility, postoperative complications, cervical intraepithelial neoplasia, etc. During pregnancy, trichomoniasis can lead to the birth of a low-weight fetus, premature birth, premature rupture of the amniotic sac, respiratory infections of the fetus. Trichomoniasis is a completely curable infection. The treatment is mainly systemic, but a combination with local therapy and vaccination is possible. A single dose of metronidazole of 2 g, a single dose of tinidazole of 2 g, or a 7-day course with metronidazole of 500 mg, twice a day, is administered systemically. Metronidazole and tinidazole work by reducing the 5-nitro group of anaerobic microorganisms. Systemic therapy can be combined with local application of the specified medications. There is also a vaccine for T.vaginalis – Solco-Trichovac, which is lyophilized inactivated strains. It is applied 3 times, 1 ampoule in 2 weeks. Treatment should be carried out in all partners who had contact with the infected person. During therapy, sexual contact is prohibited. Sources: Gynecology under the editorship of Prof. Dr. Angel Dimitrov, MD, PhD. and Prof. Dr. Viktor Zlatkov, MD, 2017 https://emedicine.medscape.com/article/230617-treatment https://www.ncbi.nlm.nih.gov/books/NBK534826/