Re: sistant Trichomoniasis

From: Richard Chudacoff, MD (rchudacoff@mylinuxisp.com)
Thu Aug 31 08:41:23 2000


I like this idea, thanks

Rick

If only complaint is nausea--what about rectal route???

"Richard Chudacoff, MD" wrote:

> Okay Bob, I mean Joe. Although, Sanford does list the alternative of
vaginal > gel in pregnancy. Still, since she cannot take MTDZ orally, and it doesn't
> work vaginally, what do you recommend?
>
> Rick
>
> -----Original Message-----
> From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net]On Behalf Of
> DoctorJoe@aol.com
> Sent: Wednesday, August 30, 2000 5:04 PM
> To: Multiple recipients of list OB-GYN-L
> Subject: Re: resistant Trichomoniasis
>
> In a message dated 8/30/00 2:37:41 PM, rchudacoff@mylinuxisp.com writes:
>
> << I have 22 yo G7 P1 (new patient, no old records, swears these are all
>
> spontaneous Abs) who presented at her new OB visit with Trichomoniasis. I
>
> treated her with oral Metronidazole, which she could not tolerate (GI
>
> upset). I then treated her with Metrogel for 7 days, and she returned with
a >
> positive test of cure. I repeated the gel for 14 day, and again she is
>
> positive on wet mount. Her husband has been on an oil rig for a couple of
>
> months and she states she has not had intercourse with anybody.
>
> What is interesting is the Trichamonads are now more rounded and slightly
>
> larger, but still one can see the flagellum beating.
>
> What do you use for resistant Trichomoniasis? Do you think this could be
>
> something else? >>
>
> Well, technically speaking, if she didn't take a complete oral course,
then > she's not "resistant," she's been insufficiently treated. Vaginal gel is
not > effective against trich (only gets those in the immediate vicinity, not in
> the bladder, etc, etc.). What she NEEDS is a week course of oral
> metronidazole, although that seems to be a problem in your patient...
>
> Joe P.





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