Which cervical exam findings are diagnostic of trichomoniasis?

Updated: Jan 02, 2020
  • Author: Darvin Scott Smith, MD, MSc, DTM&H; Chief Editor: Michael Stuart Bronze, MD  more...
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Answer

One of the classic signs of ​T vaginalis infection is colpitis macularis, or strawberry cervix, which describes a diffuse or patchy macular erythematous lesion of the cervix. This is a specific sign of trichomoniasis but is visible in only 1%-2% of cases without the aid of colposcopy; with colposcopy, colpitis macularis is detected in up to 45% of cases. [52] Together, colpitis macularis and frothy vaginal discharge have a specificity of 99%; individually, they have positive predictive values of 90% and 62%, respectively.

Lower-abdominal tenderness may be present, although this is described in fewer than 10% of patients. If this occurs, coexisting salpingitis or an intra-abdominal pathology is possible.


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