Strawberry cervix is seen in
Correct Answer: Trichomonas vaginalis
Description: FeatureNormal Vaginal ExaminationVulvovaginal CandidiasisTrichomonal VaginitisBacterial VaginosisEtiologyUninfected; lactobacilli predominantCandida albicansTrichomonas vaginalis (strawberry cervix)Associated with Gardnerella vaginalis, various anaerobic and/or noncultured bacteria, and mycoplasmas Typical symptomsNoneVulvar itching and/or irritationProfuse purulent discharge; vulvar itchingMalodorous, slightly increased dischargeDischarge AmountVariable; usually scantScantOften profuseModerate ColoraClear or translucentWhiteWhite or yellowWhite or grey ConsistencyNonhomogeneous, floccularClumped; adherent plaquesHomogeneousHomogeneous, low viscosity; uniformly coats vaginal wallsInflammation of vulvar or vaginal epitheliumNoneErythema of vaginal epithelium, introitus; vulvar dermatitis, fissures commonErythema of vaginal and vulvar epithelium; colpitis macularisNonepH of vaginal fluidbUsually 4.5Usually 4.5Usually 5Usually >4.5Amine ("fishy") odor with 10% KOHNoneNoneMay be presentPresentMicroscopycNormal epithelial cells; lactobacilli predominantLeukocytes, epithelial cells; mycelia or pseudomycelia in up to 80% of C. albicans culture-positive persons with typical symptoms Leukocytes; motile trichomonads seen in 80-90% of symptomatic patients, less often in the absence of symptomsClue cells; few leukocytes; no lactobacilli or only a few outnumbered by profuse mixed microbiota, nearly always including G.vaginalis plus anaerobic species on Gram&;s stain (Nugent&;s score 7) Other laboratory findingsIsolation of Candida spp. Isolation of T. vaginalis or positive NAATdUsual treatmentNoneAzole cream, tablet or suppository--e.g., miconazole or clotrimazole once daily for 7 days Fluconazole single doseMetronidazole or tinidazole single dose Metronidazole 7 daysMetronidazole for 7 daysMetronidazole gel once daily for 5 days Clindamycin, 2% cream vaginally each night for 7 daysUsual management of sexual panerNoneNone; topical treatment if candidal dermatitis of penis is detectedExamination for STD; treatment with metronidazole, 2 g PO (single dose)None (Ref: K.D Chatterjee 13th edition, p49)
Category:
Microbiology
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