Trichomoniasis (in males)

15-50% of men with Trichomonas are asymptomatic (1).

T. vaginalis produces a low-grade urethritis. The incubation period is 4 days to 3 weeks.

The patient may complain of mild discharge and dysuria. On examination, there may be a slight clear or grey urethral discharge. No meatal inflammation is usually seen. Urethral irritation, frequency, and rarely, balanoposthitis may be present (1).

Investigations include examination of urethral secretions and urine examination - two-glass test (the first glass characteristically contains comma-shaped specks).

Treatment is with metronidazole or tinidazole (1).

• metronidazole 400 mg twice a day for 5-7 days or 2 g as a single dose if compliance is a problem
  • or
• tinidazole 2 g as a single dose

Key points (2):

• oral treatment needed as extravaginal infection common
• treat partners, and refer to GUM for other STIs

Reference:

• (1) BASHH (2007) United Kingdom national guideline on the management of Trichomonas vaginalis. British Association of Sexual Health and HIV
• (2) Public Health England (June 2021). Managing common infections: guidance for primary care