Diagnosis of Trichomonas vaginalis Infection

To the Editor.—  In the QUESTIONS AND ANSWERS section of The Journal (241: 1176, 1979), E. Stewart Taylor, MD, recommended treatment of asymptomatic women with evidence of Trichomonas vaginalis on their Papanicolaou smears. It is my belief that treatment should be reserved for those patients in whom infection is confirmed after careful examination and wet smear. Although a few cytological laboratories may be capable of identifying trichomonal infection when present, the majority may not be sufficiently accurate to warrant treatment on the basis of the Papanicolaou smear alone.^1-5 In one study of 666 women with evidence of T vaginalis on their Papanicolaou smears, there was no evidence of the organism on wet smear or culture in 246 (37%) of these patients.Before a physician treats a patient and her consort for T vaginalis infection simply on the basis of her Papanicolaou smear, he should first investigate the accuracy of