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Vaginal discharge and microscopy — DFSRH MCQ

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HardSTI diagnosis and managementVaginal discharge and microscopyDFSRH

A 27-year-old has frothy vaginal discharge, vulval soreness and postcoital bleeding. Vaginal pH is 6.0 and microscopy shows motile flagellates. Pregnancy test is negative. What is the most appropriate management?

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Correct answer: D — Treat trichomoniasis and arrange partner treatment

Motile flagellates with high pH and frothy discharge indicate Trichomonas vaginalis. Partner treatment and abstinence until treatment is complete reduce reinfection. Candidiasis usually has lower pH and microscopy findings differ; BV treatment without partner consideration would miss the STI diagnosis.

Reference: BASHH Trichomonas Guideline; BNF