17.    The picture shows the external genitalia of a woman who presents with a 2-day duration of fever.

a)        Describe what you see.

           A frothy yellowy white discharge.

b)         You take a high vaginal sample, mix it with a drop of saline and look at it under the microscope. You see a flagellate parasite. What is the diagnosis? 

            Trichomonas vaginalis.

c)         Where else apart from the vagina would you find this organism? 

            1.    Urethra.

             2.    Upper genital tract. 

d)         How is this organism acquired?

            Sexually.

e)        Name three aspects of your management.

            1.    Give metronidazole to treat infection.

            2.    Advise barrier contraception until disease resolves.

            3.    Screen and treat the partners.

f)         What follow-up would you arrange?

            Repeat swabs after treatment.

g)         What is the most common cause of vaginal discharge?

             Candida.