CASE REPORT

Concurrent infections of Trichomoniasis and nongonococcal cervicitis in a menopausal woman: a case report

Ni Luh Putu Ratih Vibriyanti Karna

Ni Luh Putu Ratih Vibriyanti Karna
Department of Dermatology and Venereology, Faculty of Medicine, Universitas Udayana, Sanglah General Hospital, Bali, Indonesia. Email: r.vibriyanti@gmail.com
Online First: April 01, 2020 | Cite this Article
Karna, N. 2020. Concurrent infections of Trichomoniasis and nongonococcal cervicitis in a menopausal woman: a case report. Bali Medical Journal 9(1): 318-322. DOI:10.15562/bmj.v9i1.1644


Background: Trichomoniasis is a rare, sexually transmitted infection. Trichomoniasis can often coincide with other pathogens that cause genital infections. Menopausal women remain at risk of developing this disease due to physiological and anatomical changes in the female genital organs.

Case: A woman, age 61 years, experience vaginal discharge from one month with itching in the genital area. The last menstruation period was 7 years ago. The patient had one sexual intercourse a month ago with her boyfriend; it was the first sexual contact since 7 years ago, without using a condom.

Result: Pelvic examination reveal vaginal wall erythema, yellowish discharge on the fornix posterior, and cervical, watery consistency. Leukocytes 20-25 per field view and Trichomonas vaginalis was found on laboratory examination. pH examination on the vagina was 8. The patient was diagnosed with Trichomoniasis, and nongonococcal cervicitis was given metronidazole 2 x 500 mg, azithromycin 1000 mg single dose for therapy. After therapy with metronidazole, there is an increase in pH that occurred a week after therapy, which amounted to 10 and decreased one week later to 8. An increase in leukocytes also accompanied increased pH in cases, so that co-infection with other germs should be considered. 

Conclusion: Examination of wet vaginal preparations revealed trichomonas vaginalis that are alive and moving. In follow-up observations, there was an increase in vaginal pH and increased leukocytes in the vaginal gram. Specific causative bacteria were not found, and thus, the patient was diagnosed with a non-specific genital infection on further observation.

References

Garcia AL, Madkan VK, and Tyring SK. Gonorrhea and other veneral diseases. In: Freedberg IM et al, eds. Fitzpatrick’s Dermatology In General Medicine, 7th ed. New York: McGraw-Hill. 2008. p1993-1997.

Hobbs MM, Sena AC, Swygard H, and Schwebke JR. Trichomonas vaginalis and Trichomoniasis. Eds. Sexually Transmitted Disease, 4th ed. New York: McGraw Hill. 2008. p771-787.

Schwebke JR. Trichomoniasis. Current Diagnosis and Treatment Sexually Transmitted Disease. International ed. United States of America: Mcgraw Hill. 2007. p116-119.

Baziad A. Menopause dan Andropause. Jakarta: Yayasan Bina Pustaka Sarwono Prawirohardjo. 2003. p3-6.

Murtiastutik D. Trikomoniasis Vaginalis. Dalam Buku Ajar Infeksi Menular Seksual. Surabaya: Airlangga University Press. 2008. p65-71.

American Congress of Obstetricians and Gynecologists. ACOG technical bulletin. Vaginitis. Number 226-July 1996 (replaces No. 221, March 1996). Committee on Technical Bulletins of the American College of Obstetricians and Gynecologistss. Int J Gynaecol Obstet. 1996; 54. p293-302.

Mendling W, Brasch J. Guideline vulvovaginal candidosis. 2010. p1-13.

Hammill HA. Normal vaginal flora in relation to vaginitis. Obstet Gynecol Clin North Am. 1989. p329-336.

Johnston SL, Farrell SA, Bouchard C, Farrell SA, Beckerson LA, Comeau M, et al. The detection and management of vaginal atrophy. J Obstet Gynaecol Can. 2004. p503-515.

Lutters M, Vogt-Ferrier NB. Antibiotic duration for treating uncomplicated, symptomatic lower urinary tract infections in elderly women. Cochrane Database Syst. 2008.


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