Management of a 42 year old female patient diagnosed with trichomoniasis is described. She failed to respond to recommended oral and high dose oral and topical metronidazole. Various options used in previously reported cases of metronidazole resistant trichomoniasis also failed to cure her condition. MIC showed the organism to be resistant to metronidazole. Cure was achieved with the use of topical intravaginal paromomycin.
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