Trichomonas vaginalis trichomoniasis Trichomonas vaginalis Amal Hassan

Introduction A sexually transmitted disease (STD), also known as sexually transmitted infection (STI) or venereal disease (VD), is an illness that has a significant probability of transmission between humans or animals by means of sexual contact

which is a serious sexually transmitted pathogen. Genus Trichomonas Its includes a group of flagellated protozoa It infect humans and animal Human Trichomonads: 3 species of trichomonads found in human. Two are normally harmless. T. hominis which inhabit large intestine & non pathogenic. T. tenax which inhabit oral cavity & commensals. T. vaginalis is the Urogenital pathogenic flagellate which is a serious sexually transmitted pathogen.

Urogenital flagellate: Trichomonas vaginalis Causes : Trichomoniasis Geog. Distribution : worldwide Habitat: T. vaginalis trophozoite lives: In the vagina and urethra of infected females. In the urethra and Prostate of infected males (Never becomes cyst) Transmitted directly during sexual intercourse from infected partner to the other,and during dealings with contaminated matters (clothes, cotton..etc) axostyle flagella Nucleus

T. Vaginalis trophozoite Fg=flagella Bb=basal body Nu=nucleus Ax=axostyle um=undulating membrane Cy=cytostomal groove Cs=costa No Cyst stage

Life cycle: flagella are found in the genital tract.

Pathogenesis and Clinical picture In women Trophozoites feed on mucosal surface of vagina and urethra producing sloughing of squamous epithelial cells Asymptomatic (50%) Profuse odourous (foul-smelling) discharge, burning, itching, dyspareunia, frequency of urination and dysuria. On examination: Excessive discharge, diffuse vulval erythema Vaginal wall inflammation (Strawberry cervix) vagina Pathogenesis and Clinical picture

Infection is frequently asymptomatic In men Infection is frequently asymptomatic Symptoms appear when infection involves prostate or higher part of uro-genital tract. Thin discharge and dysuria Enlarged tender prostate and epididymitis prostate On examination urethra epididymus

Vaginitis - Trichomoniasis Profuse, frothy discharge, yellow-greenish in color foul odor, vulvar pruritus Patchy vaginal erythema and (strawberry cervix)

Diagnosis Microscopic examination of wet film from discharge Culture of discharge. (modified Diamond’s media) Detection of T.vaginalis antigen in discharge by: Enzyme immunoassay. Direct fluorescent antibody test. Detection of DNA of the parasite by Molecular techniques

Epidemiology and Control Treatment Metronidazole + Vinegar vaginal douche Treatment of sexual partner simultaneously Epidemiology and Control and Control Most common between humans at the age of 16-35 High incidence in ladies with deficient feminine hygiene Treatment of the patient and the sexual partner simultaneously Diagnosis and treatment of asymptomatic males Use of condoms to prevent infection