Trichomonias

is
By
2nd Group
 Member of Group
Badiatul Khilqoh 6130014011
Claudia Narinda Rahma Putri 6130014012
Dinda Mutiara Sukma P 6130014013
Maimunah Faizin 6130014014
Elsa Kusumawati 6130014015
Nuris Umi Rizqi 6130014016
Hessty Rocheendah Onjiah 6130014017
Sri Safariawati M.A.A 6130014018
Luthfi Kalindra Parahita 6130014019
Aanisah Ikbar Sayyidah 6130014020
 Scenario

A woman 24 years coming to Jemursari

Islamic Hospital with complaints of fluid
out of his cock (vagina). Considered a long
time and often change the bandage.
Patients feel itchy and smelly on his
vagina. Patients often use vaginal cleaning
fluid
Identification of Difficult Words

1. Douching: liquid used to clean the

vagina
Keywords

1. Female 24 years
2. Discharge and pubic long ago
3. Frequent change the bandage
4. Itching and smell in pubic
5. Frequent use vaginal cleaning fluid
Mind Mapping
Hypothesis

Obtainment trichomonas in laboratory

tests in the diagnosis of trichomoniasis
women
Learning Objective

1. Explain the diagnosis and differential diagnosis of trichomoniasis

2. Describe the etiology and risk factors of trichomoniasis
3. Explain the investigations should be done
4. Explain the physiology of fluor albus
5. Explain the pathogenesis of trichomoniasis
6. Describe the pathophysiology of trichomoniasis
7. Describe the clinical manifestations of trichomoniasis
8. Describe the management of trichomoniasis
9. Describe the complications of trichomoniasis
10. Explaining the Islamic view related to scenario
 Diagnose Of Trichomoniasis

1. Clinical Diagnoses 2. Laboratory Diagnoses

which attacked mainly the
vaginal wall.
seropurulen vaginal secretions A. Microscopic
yellowish, yellow-green, foul examination.
smelling (malodorous), and
foamy. B. Culture
Vaginal walls appear red and C. Serology and
swollen "strawberry appearance"
Immunology
dyspareunia
postcoital bleeding
 Differential Diagnos

Bacterial
Candidiasis
vaginosis

Urethritis non
gonorrhea
 Etiolog
y

Trichomonas vaginalis. Trichomonas

vaginalis is included in the domain
Eukarya, protist kingdom, phylum
Metamonada included in protozoa that
flagellates. Parabasilia class,
Trichomonadida order, genus Trichomonas,
and species Trichomonas vaginalis
 Risk factors

1. Multiple Sex Partners (more than one sex

partner)
2. Being infected with a sexually transmitted
disease or previously infected with other
sexually transmitted diseases
3. Bacterial vaginosis
4. high PH of vagina
 Trichomoniasis test

Wet mount
VPIII Microbial Identification Test (BD)
Trichomonas Rapid Test
Polymerase Chain Reaction
Whiff test
Vagina pH test
PAP smear
 Physiological vaginal
discharge

hormonal factors fluid mucus many epithelial

and few leukocytes.
- secretions of vulvar vaginal
- cervical secretions
- secretions of the uterus
- or fallopian tube secretion
 Physiological vaginal discharge can be found at:

1. Newborns up to the age of approximately 10 days; This is

caused by the effects of estrogen on the uterus and
vagina placenta to the fetus
2. Time around menarche due to start there is the influence
of estrogen;
3. Adult women when he is stimulated before and during
coitus, caused by spending a transudate from the
vaginal wall.
4. The time around ovulation
5. physical and mental fatigue is also a cause of vaginal
discharge.
 Patogenesis and Patophysiology

Trichomonas Attack the

vaginalis enter to squamous
vagina due to epithelium cell of
many causes vagina directly

Release toxic Begin to multiply

substance actively in vagina

Production of lactic
Supply of glycogen
acid decrease, so
for Lactobacillus
vagina pH will
Dderlein reduced
increase, and PMN
even nothing at all
cells also increase
Clinical Manifestations
Trichomonas vaginalis
Characterized by:
May be asymptomatic in women
Vaginitis
Frothy gray or yellow-green vaginal discharge
Strong odor
Pruritus
Cervical petechiae ("strawberry cervix") - classic
presentation, occurs in minority of cases
May also infect Skene's glands and urethra, where the
organisms may not be susceptible to topical therapy
 Clinical Manifestations
May cause up to 11%-13% of
nongonococcal urethritis in males
Urethral trichomoniasis has been
associated with increased shedding of
HIV in HIV-infected men
Frequently asymptomatic
 Treatment
Recommended Regimen
Metronidazole2 g orally in
a single dose
OR
Tinidazole2 g orally in a
single dose
Alternative Regimen
Metronidazole500 mg
orally twice a day for 7 days
And Management for Sex
Partners
Prevention of infection
caused by Trichomonas
vaginalis can be done with
counseling and education to
patients and the general
public about this infection as
well as the diagnosis and the
correct handling of the pair
trichomoniasis patients. The
use of condoms can be used
as one way to prevent
transmission of the infection
to sexual partners
 COMPLICATION

Trichomoniasis scaling up the risk of Pelvic

Inflammatory Disease (PID), HIV, gonorrhea,
and chlamydia.
Trichomoniasis cause premature birth or low
birth weight infants.
Trichomoniasis associated with less increase
in the possibility of carcinoma of the cervix
Infection in men increases the risk of
prostate carcinoma.
 ISLAMIC VIEWS

Muslims are required to maintain the

cleanliness of birth and his/her inner.
Maintain the cleanliness of the inner and
outer traits is part of faith in his life. As in a
hadith which means: "The religion of Islam
(religion) is clean, then let you maintain
cleanliness, for surely will not enter Paradise
except those who are clean" (HR. Baihaqy).
Cleanliness was sourced from the faith and
are part of the faith. As in a hadith which
means: "Cleanliness was part of faith". (HR.
Ahmad)
Conclusion
The use of a vaginal cleanser in women can lead to changes
in pH of the vagina which is initially towards the acid into
the direction of the base, causing the decreased of normal
flora and flora pathogens is increased, causing flour albus is
pathogen caused complaints of itching and odor, as well as
on examination of lab, trichomonas + suggesting that
patients suffering from trichomoniasis so that management
can be done by giving antibiotics and treatment in couples
and appropriate education.