Trichomoniasis

Trichomonas vaginalis - Ilustration

Trichomoniasis is the most common nonviral sexually transmitted infection (STI). Approximately 5 million women in the United States are infected annually. This may actually be an underestimate of the incidence of trichomoniasis. Screening methods are relatively insensitive and this infection is often not reported. It is caused by a protozoan, Trichomonas vaginalis. Infection with T vaginalis is easily transmitted sexually and is associated with an increased risk of acquiring HIV. The mechanism of action is thought to be an increase in the vaginal secretions of CD4+ cells, which serve as target cells for the HIV virus. Furthermore, trichomoniasis infection is also associated with coinfection with other STIs.

Symptoms

Vulvovaginal Candidiasis

Vulvovaginal Candidiasis

Vulvovaginal Candidiasis (VC) is the most common cause of infectious vaginitis, accounting for between 40% and 50% of all cases. It may cause genital discomfort, loss of productivity, reduced sexual pleasure, psychological problems, and medical expenses.[36] Seventy-five percent of reproductive-age women will have at least one episode of VC in their lifetime, and 40% to 45% will have two or more episodes.[1,38]

Candidal infection is most often caused by Candida albicans, a fungal organism that is a part of the normal flora of the vagina of reproductive-age woman, but causes >90% of cases of symptomatic vaginitis. However, infection can also be caused by other species, such as C glabrata and C tropicalis. The latter two types often are more resistant to treatment.[25] The relationship between colonization of the vagina (growth of C albicans on vaginal culture) and vaginitis symptoms is not understood. Certain factors are predictive of yeast colonization: positive HIV status, having diabetes, recent IV drug use, and recent antibiotic use.[1,37] It is thought that other host factors play a role in whether or not women are symptomatic because a large number of women who are colonized have no symptoms.[37] VC is classified as uncomplicated or complicated based on frequency, symptoms, microbiology, and response to treatment ( Table 3 ).