Question:
A young sexually active female presents with intense pruritus and a watery vaginal discharge. A wet-mount smear is examined. What does the smear most likely show?
A young sexually active female presents with intense pruritus and a watery vaginal discharge. A wet-mount smear is examined. What does the smear most likely show?
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Itching plus watery (frothy) discharge with motile flagellates on wet smear.
Updated On: Jun 24, 2026
- Trichomonas vaginalis
- Candida vaginitis
- Gardnerella vaginalis
- HIV
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The Correct Option is A
Solution and Explanation
Step 1: The clinical picture is a classic case of trichomoniasis. A sexually active woman with intense vulvovaginal pruritus and a thin, watery (often frothy, greenish-yellow) discharge points strongly to Trichomonas vaginalis.
Step 2: The key is the word smear. A wet-mount (saline) smear in trichomoniasis shows motile, pear-shaped, flagellated protozoa with a jerky twitching motility, which is diagnostic on direct microscopy.
Step 3: Why the distractors are wrong. Candida vaginitis gives a thick, white, curdy discharge with itching and shows budding yeasts and pseudohyphae on KOH, not a watery discharge. Gardnerella (bacterial vaginosis) gives a thin gray homogeneous discharge with a fishy odour and clue cells, and is typically non-pruritic. HIV is a systemic retroviral infection and is not identified on a vaginal wet-mount smear, so it cannot be the smear finding.
Step 4: Therefore the smear shows Trichomonas vaginalis.
Step 2: The key is the word smear. A wet-mount (saline) smear in trichomoniasis shows motile, pear-shaped, flagellated protozoa with a jerky twitching motility, which is diagnostic on direct microscopy.
Step 3: Why the distractors are wrong. Candida vaginitis gives a thick, white, curdy discharge with itching and shows budding yeasts and pseudohyphae on KOH, not a watery discharge. Gardnerella (bacterial vaginosis) gives a thin gray homogeneous discharge with a fishy odour and clue cells, and is typically non-pruritic. HIV is a systemic retroviral infection and is not identified on a vaginal wet-mount smear, so it cannot be the smear finding.
Step 4: Therefore the smear shows Trichomonas vaginalis.
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