Difference Between Trichomoniasis and BV

Key Difference – Trichomoniasis vs BV
 

Trichomoniasis and bacterial vaginosis are two commonly misdiagnosed conditions that have a similar clinical presentation. Trichomoniasis is a sexually transmitted disease (STD) caused by a flagellated protozoon named Trichomonas vaginalis. An organism named Gardnerella vaginalis causes bacterial vaginosis which is characterized by an offensive vaginal discharge. Although trichomoniasis is considered as a sexually transmitted disease, bacterial vaginosis is not included in that category because its causative agents are not known to spread the disease through sexual contact. This is the key difference between trichomoniasis and BV.

CONTENTS

1. Overview and Key Difference
2. What is Trichomoniasis 
3. What is BV
4. Similarities Between Trichomoniasis and BV
5. Side by Side Comparison – Trichomoniasis vs BV in Tabular Form
6. Summary

What is Trichomoniasis?

Trichomoniasis is a sexually transmitted disease that is caused by a flagellated protozoon named Trichomonas vaginalis. This organism adheres to the overlying squamous epithelium of the vagina and urethra, resulting in the infection of those regions. Babies can also get this disease in their passage through the genital tract during the delivery.

Clinical Features

Usually, the infected women remain asymptomatic

• Vaginal discharge
• Local irritation
• Urethral discharge, urinary frequency, and irritation in infected men

During the examination, erythematous vaginal walls and a yellowish discharge can be observed. Cervix has a characteristic strawberry cervix appearance due to the presence of tiny hemorrhagic lesions on the cervical walls. Trichomoniasis infection during the pregnancy increases the likelihood of preterm labor and low birth weight.

Diagnosis

• Dark-ground microscopy reveals the presence of Trichomonas vaginalis along with a large number of polymorphonuclear lymphocytes.
• Culturing of the organisms confirms the diagnosis

Treatment

• Oral metronidazole is the drug of choice in treating bacterial vaginosis. The male sexual partners should also be treated regardless of the absence of symptoms.

What is BV?

Bacterial vaginosis is a disease characterized by an offensive vaginal discharge. Typically, the lactobacilli that constitute the normal vaginal flora are replaced by pathogens such as Gardnerella vaginalis and anaerobic organisms such as bacteroides and mobiluncus. The amines produced by these organisms are thought to be the cause of the foul odor seen in this condition. There are no associated inflammatory reactions. Bacterial vaginosis is not a sexually transmitted disease.

Clinical Features

• Greyish white vaginal discharge with a foul smell
• Some patients can remain asymptomatic
• There can be complications such as premature labor in pregnant women and chorioamnionitis

Diagnosis

At least three of the following criteria should be present to make a diagnosis of bacterial vaginosis.

• Characteristic vaginal discharge
• The amine test giving a pH value more than 4.7
• The fishy odor on mixing a drop of discharge on 10% potassium hydroxide
• Presence of clue cells on the microscopic examination of the vaginal fluid

Clue cells are the vaginal epithelium cells that have got a granular appearance due to the adherence of bacteria to their surface.

Treatment

• Oral metronidazole given in 400 mg doses twice a day for 5-7 days.
• Intravaginal application of 2% clindamycin cream once a day for 7 days.

What are the Similarities Between Trichomoniasis and BV?

• Both are infectious diseases.
• Both have a similar clinical picture with characteristic foul-smelling vaginal discharges.
• Both BV and trichomoniasis can be a cause of preterm labor.

What is the Difference Between Trichomoniasis and BV?

Trichomoniasis vs BV
Trichomoniasis is a sexually transmitted disease that is caused by a flagellated protozoon named Trichomonas vaginalis.	Bacterial vaginosis is a disease characterized by an offensive vaginal discharge.
Method of Transmission
This is a sexually transmitted disease.	This is not a sexually transmitted disease.
Causative Agent
The causative agent is Trichomonas vaginalis.	There are multiple causative agents such as Gardnerella vaginalis and anaerobic organisms such as bacteroides and mobiluncus.

Summary – Trichomoniasis vs BV

Trichomoniasis is a sexually transmitted disease that is caused by a flagellated protozoon named Trichomonas vaginalis. Bacterial vaginosis is a disease characterized by an offensive vaginal discharge that caused by multiple causative agents such as Gardnerella vaginalis, bacteroides and mobiluncus. Although trichomoniasis is a sexually transmitted disease (STD), bacterial vaginosis is not considered as an STD.  This is the basic difference between trichomoniasis and BV.

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References:

1. Kumar, Parveen J., and Michael L. Clark. Kumar & Clark clinical medicine. Edinburgh: W.B. Saunders, 2009.

Image Courtesy:

1. “Trichomoniasis 01” (Public Domain) via Commons Wikimedia
2. “Vaginose-G15” by Per Grinsted / Medicinsk Webdesign (CC BY-SA 3.0) via Commons Wikimedia