Recalcitrant Trichomonas vaginalis infections successfully treated with vaginal acidification.

Background: Recalcitrant vaginal trichomoniasis is extremely distressing for patients and frustrating for physicians because there are no current guidelines for treatment. Numerous studies have shown that an increase in vaginal pH creates a better environment for the growth of Trichomonas vaginalis. We describe two patients with recalcitrant trichomoniasis who were successfully treated using vaginal acidification.

Cases: The first patient with trichomoniasis had a severe reaction to metronidazole, but the infection subsequently resolved after treatment with a combination of boric acid and clotrimazole. The second patient with resistant trichomoniasis had been treated unsuccessfully with multiple courses of metronidazole but was treated successfully with vaginal acidification using boric acid.

Conclusion: A process of vaginal acidification resulted in resolution of recalcitrant Trichomonas vaginalis in two patients.