Trichomonas Vaginalis (阴道毛滴虫) Inhabit --- Female: vagina, urethra --- Trichomonas vaginitis, Trichomonas urethritis --- Male: urethra, prostate gland --- Trichomonas urethritis
乒乓(ping-pong)感染
undulating 1. Morphology Trophozoite pyriform or oval 4 anterior flagella Trophozoite 1 nucleus colorless pyriform or oval 1030μm×1015μm undulating membrane (1 posterior flagellum) axostyle
Trophozoites – Gimsa stain
Four anterior flagella The single lateral flagellum (the undulating membrane(波动膜）
2. Life cycle (One host, one stage)
Male--urethra, prostate gland Inhabiting sites： Infective stage： Mode of infection： Female--vagina, urethra Male--urethra, prostate gland Trophozoit (Multiplies by longitudinal binary fission) Direct contact： sexual intercourse Contact Indirect contact： sharing the hygiene utilities
(1)Pathogenic mechanism 3. Pathogenesis (1)Pathogenic mechanism 1）Contact-dependent cytopathic effect： surface proteins： responsible for cell adherence cell-detaching factor：causes detachment of the host’s cell
Self-cleaning function of vagina: vaginal epithelium （rich in glycogen） Control the growth and reproduction of parasites Bacilli（杆菌） (normal flora) convert lactic acid Women Under Normal condition The viginal Secretions: pH3.8-4.4 Non-pathogenic
Reduction in acidity of vagina The trophozoites multiplies rapidly Women under some conditions (pregnancy, after Menses, etc. Reduction in acidity of vagina (of pH rising above 5.0) If T.v infects the women at this time The trophozoites multiplies rapidly Vaginitis Because of the T.v competitively take advantage of the glucogen, the pH of the vagina rises up higher and is therefore advantage of growth of other pathogenic bacteria.
Reddened vaginal mucosa can be seen. (2) Pathologic changes Reddened vaginal mucosa can be seen. In severe cases, petechial hemorrhages is present. (3) Clinical manifestation 1）Vaginitis white, frothy discharge (creamy white in color, full of bacteria ) ，foul-smelling Itching, Vaginal burning, The vaginal secretions are liquid, greenish or yellow Frequency of urination(撒尿), Dysuria
2) In male： Usually asymptomatic Frequency of urination Dysuria Prostate may be enlarged , Prostatitis
(1)Parasitic diagnosis： 1） Direct smear ① Saline smear(生理盐水涂片) ② Staining specimen： Discharge from posterior vaginal fornix, Urine, Secretion of prostate gland 2）Cultivation：specimen above，37℃，48h， microscopic exam (2)Immunologic test：Ag detection (3)DNA probe
5. Epidemiology (1)Didtribution： world wide, especially in female at the age group of 20～40, average prevalence is 28％. In America：2 ~ 3million infective cases per year In China：wide spread
1）The source of infection：patient、carrier (2)Transmission 1）The source of infection：patient、carrier （ including male） 2）The route of infection： ①Direct contact：sexual intercourse (STD) ②Indirect contact：public bathtub , towels, toilet seats, bathing suit The trophozoites have strong resistance to the outside environment : The trophozoits can survive for 14h ~ 20h in semi-drying environment, for 7h at -10 ℃ ， for 102h at 40 ℃, for 30 min on toilet seat, for 45h ~ 150h in soap-water
6. Treatment and Prevention (1) Control of infective sources：screening detection of patients and carriers Oral administration：Metronidazole, Tinidazole Remark: sexual partners must be treated at the same time (2) Block the routes of transmission：Improve the public swimming pool, toilet, etc， (3) Protection of population: Keep good personal hygiene， Safer Sex