Patient is a 30-year-old single, heterosexual male who presented to the Family Medicine clinic with a 5-day history of sore throat and a painful right-sided neck mass; he denied cough, sneezing, rhinorrhea, fever and exposure to tuberculosis. Further investigation revealed participation in unprotected oral sex with his partner for 1 year, who had recently been diagnosed with vaginal trichomoniasis and was prescribed metronidazole.
Patient presented with an enlarged right anterior cervical lymph node, measuring 4.5 cm x 3 cm, and was non-tender at the time of the examination; patient states that he had been taking acetaminophen for the pain. Examination of the oral mucosa revealed good oral hygiene, with pharyngeal and right tonsillar exudates. Rapid streptococcal test and throat culture were negative for group A Streptococcus. Pharyngeal and tonsillar exudates using a Gen-probe Aptima Unisex Swab Kit (blue swab) tested positive for T. vaginalis by nucleic acid amplification test (NAAT). Screening was negative for HIV, syphilis, chlamydia, gonorrhea and tuberculosis. Our patient's symptoms resolved with oral metronidazole 2 g. We are reporting this case because there is no known case of oral infection from T. vaginalis reported in the literature.