Biological Sciences
Trichomoniasis
Trichomoniasis is a sexually transmitted infection caused by the parasite Trichomonas vaginalis. It commonly affects the urogenital tract in both men and women, leading to symptoms such as vaginal discharge, itching, and discomfort during urination. While it can be treated with antibiotics, trichomoniasis can lead to serious complications if left untreated, making early detection and treatment crucial.
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11 Key excerpts on "Trichomoniasis"
eBook - PDF- Nancy Malla(Author)
- 2012(Publication Date)
- IntechOpen(Publisher)
Part 3 Protozoal Infection 6 Human Trichomoniasis due to Trichomonas vaginalis – Current Perspectives Nancy Malla Department of Parasitology, Postgraduate Institute of Medical Education and Research, Chandigarh India 1. Introduction Human Trichomoniasis caused by protozoan parasite, Trichomonas vaginalis is one of the most prevalent non-viral sexually transmitted urogenital disease with more than 180 million cases annually worldwide. Annual incidence varies between 0-65 percent depending upon different geographical locations, age groups and population studied. In North America and Canada, more than 8 million new cases are reported annually, with an estimated rate of asymptomatic cases as high as 50 percent (Sobel, 2005). The number may be underestimated as symptomatic patients may be underdiagnosed because of insensitive wet mount procedure and most of the infected subjects remain asymptomatic, thus are not being reported (Petrin et al, 1998). Recent review on Global epidemiology in high risk populations and control of T.vaginalis has highlighed that the burden of infection is found in resource-limited settings and high risk groups in industrialized settings. The World Health Organization estimated global prevalence figures are based on a wet mount microscopy (sensitivity range of 60-80%), however recent data, using PCR suggests sensitivity may be lower (35-60%), thus underestimating global prevalence (Johnston and Mabey, 2008) In India, hospital based studies reveal 4-10 percent positivity in symptomatic women attending gynaecology clinics and almost similar percentage in asymptomatic women attending infertility, post-natal and family planning clinics (Sharma et al, 1988; Malla et al, 1989; Divekar et al, 2000; Vishwanath et al, 2000;Valadkhani et al, 2003; Chakraborty et al, 2005; Yadav et al, 2006).
eBook - ePub- Lynne Shore Garcia(Author)
- 2016(Publication Date)
- ASM Press(Publisher)
25 Protozoa from Other Body Sites Trichomonas vaginalis Toxoplasma gondii Trichomonas vaginalisTrichomonas vaginalis was first isolated in 1836 from the purulent discharge from female genital organs. The infection occurs worldwide and has been found in the population whenever the appropriate specimens have been examined for the presence of the organism. It is estimated that 5 million women and 1 million men in the United States have Trichomoniasis, with the annual incidence of new cases estimated at 7.4 million (1 ). The annual incidence of Trichomoniasis worldwide is estimated to be more than 275 million cases, which does not include the number of asymptomatic cases that are not treated. In North America, more than 8 million new cases are reported yearly, with an estimated rate of asymptomatic cases being as high as 50% (1 ). Trichomoniasis is now the primary nonviral sexually transmitted infection (STI) worldwide. In women, disease manifestations may include vaginitis, cervicitis, urethritis, pelvic inflammatory disease, and adverse birth outcomes. T. vaginalis infection may also increase risk of HIV transmission, the incidence and severity of cervical and prostate cancer, and increased infertility. Some of the most recent developments in our understanding of T. vaginalis pathobiology include the increased association with HIV in terms of exposure to STIs and a positive association with aggressive prostate cancers (2 ).Population genetic analysis has shown that T. vaginalis is a genetically diverse parasite that consists of two types present in equal proportions worldwide. Parasites belonging to the two types (type 1 and type 2) differ significantly in the rate at which they harbor the T. vaginalis virus, a double-stranded RNA virus implicated in parasite pathogenesis, and in their sensitivity to the widely used drug metronidazole (3 ). The extensive clinical variability and disease sequelae are matched by significant genetic diversity in the organism itself; this strongly suggests a connection between the genetic identity of isolates and their clinical manifestations (4
eBook - PDFThe Yale Guide to Women's Reproductive Health
From Menarche to Menopause
- Mary Jane Minkin, Carol V. Wright(Authors)
- 2008(Publication Date)
- Yale University Press(Publisher)
Trichomoniasis Trichomoniasis, infection with the Trichomonas organism, is a widespread STD. It does not by law have to be reported to health authorities, so some guesswork is involved in tab- ulating the number of new cases in the United States each year. Estimates range from 3 million to 5 million new cases yearly, and some data suggest that the incidence is decreas- ing. What causes Trichomoniasis? Trichomoniasis, also known as trich (pronounced “trick”), is an STD caused by a micro- scopic single-celled organism called Trichomonas vaginalis that propels itself through its 1 5 6 s e x ua l ly t r a n s m i t t e d d i s e a s e s End of tube distorted by adhesions Fallopian tube kinked by adhesions Adhesions figure 22. Pelvic inflammatory disease can cause scar tissue to develop between organs and cause persistent pain. It can also distort the shape of the tubes or block the entrance to them, causing infertility. wet microenvironment by means of three whiplike tails called flagella. Like most of the other organisms responsible for STDs, this one is relatively fragile, cannot survive drying out, and can be cured by drug therapy. What are the symptoms? The usual symptoms in women include a foul-smelling vaginal discharge, usually yellow or yellow-green, which can be thick, thin, or frothy. Sometimes, but not always, the infec- tion causes burning, itching, or redness of the vagina or vulva. It may cause discomfort during intercourse and frequent or painful urination. About 40 percent of women diag- nosed with trich have no symptoms and thus can spread the disease without knowing it. Men can also be infected with trich, but they do not usually have symptoms. If they do, the symptoms include irritation, a discharge from the penis, or a burning sensation during urination. How do you get Trichomoniasis? In the vast majority of cases, trich is transmitted sexually.
- Dongyou Liu(Author)
- 2012(Publication Date)
- CRC Press(Publisher)
sexual. behavior . . Trichomoniasis. has.an.incubation.period.of.4–28.days.[6] . 11.1.2 C LINICAL F EATURES AND P ATHOGENESIS 11.1.2.1 Clinical Features First. described. by. Donne. in. 1836. and. long. regarded. as. a. harmless.commensal.of.the.human.vagina,. T. vaginalis .has. been.later.incriminated.as.a.cause.of.vaginitis.and.cervicitis,. in.women,.and.urethritis.in.both.sexes.[7–9] . Although.approximately.50–80%.of.women.and.a.major-ity.of.men.infected.with. T. vaginalis .are.asymptomatic,.the. parasite.is.known.to.cause.nonspecific.clinical.signs,.ranging. from.vaginal.discharge,.pruritus.(itching),.erythema,.vaginal. wall. edema,. leucorrhea,. foul. odor,. low. abdominal. discom-fort,.dysuria,.vulvar.pain,.and.dyspareunia.in.women,.and.a. self-limiting.mild.urethritis.in.men . .[2] . As.the.most.common.manifestation.associated.with.vagi-nal. Trichomoniasis,. vaginal. discharge. is. frequently. profuse. and.frothy,.along.with.burning,.itching,.or.chafing . .The.vagi-nal. mucosa. sometimes. appears. diffusely. hyperemic,. with. bright-red. punctate. lesions . . Colpitis. macularis. (strawberry. cervix).initially.develops.as.a.strong.irritable.erythema.and. progresses.into.a.group.of.small.punctate.hemorrhagic.spots. of.a.“strawberry.appearance”.on.the.vagina.close.to.the.cer-vical.mucosa . .This.specific.clinical.sign.for.vaginal.tricho-moniasis.is.detected.only.by.colposcopy.[10,11] . Furthermore,.Trichomoniasis.has.been.linked.to.increased. risk.of.HIV.transmission.and.pregnancy.complications.(e .g., . premature.rupture.of.placental.membranes,.premature.labor. and.low.infant.birth.weight).[12–14] . 11.1.2.2 Pathogenesis Adhesion.of. T. vaginalis .parasites.to.target.cells.(e .g., .vaginal. epithelial. cells). represents. a. prerequisite. for. the. establish-ment.of.infection,.cytotoxicity.toward.mammalian.cells.and. thus.pathogenesis.of.Trichomoniasis.[7,15,16] . .Adherence.is.a. multifactor.process,.involving.microtubules,.microfilaments,.
- Faro Sebastian, Gilles R. G. Monif, David A. Baker, Gilles R. G. Monif, David A. Baker(Authors)
- 2008(Publication Date)
- CRC Press(Publisher)
INTRODUCTION Donne, in 1830, observed organisms on slides of puru-lent discharges from the genital tracts of men and women and named them Trichomonas vaginale . The name Trichomonas vaginalis was suggested two years later by Ehrenberg. Since then, over 100 separate species of the genus Trichomonas have been reported, but only three have been isolated in humans. T. vaginalis is the only species of the trichomonads that is pathogenic for humans. T. tenax and T. hominis infect the human gas-trointestinal tract, but as harmless commensals. Although it is primarily a sexually transmitted disease (STD), the demography of disease suggests that it may be transmitted by an alternate mode. Prevalence studies have demonstrated two peaks: one in young sexually active women and the second in older women who have no evidence of sexually transmitted infection. T. vaginalis is a tetraflagellated, motile protozoon with an anterior nucleus, an anterolateral undulating mem-brane, and a prominent axostyle (Fig. 1). Usually, the organism’s shape is oval or fusiform and its size is slightly larger than that of the average leukocyte (15Ê). However, under adverse conditions or with certain strains, its shape may be round or pear shaped, and its size considerably smaller (7Ê–13Ê) or larger (20Ê–30Ê) (Fig. 2). An oval nucleus, which appears more dense than the surrounding cytoplasm, is located toward the fla-gellated pole and is usually 1/3 to 1/2 the length of the organism. The cytoplasm is basically clear but fre-quently contains varying amounts of cytoplasmic parti-cles, vacuoles, debris, and bacteria. Rarely, intracytoplasmic leukocytes or erythrocytes may be identified. Reproduc-tion is by mitotic division of the nucleus and longitudinal fission into two daughter cells. The organism is believed to exist only in the trophozoite form; a cyst form has not been found.
eBook - PDF- Fiona M. Lewis(Author)
- 2022(Publication Date)
- Wiley-Blackwell(Publisher)
Figure 14.2 Discharge associated with trichomonas infection. Source: Published in Wisdom , A and Hawkins, D. Diagnosis in Color: Sexually Transmitted Diseases , 2nd edn. Mosby-Wolfe, London slide 276, p. 160, © Elsevier 1997. -e e erences 93 References 1 World Health Organization. Global incidence and prevalence of selected curable sexually transmitted infections 2008. (http://apps.who.int/iris/bitstr eam/10665/75181/1/9789241503839_eng.pdf. Last accessed May 2021.) 2 Mitchell, H.D., Lewis, D.A., Marsh, K. et al. Distribution and risk factors of Trichomonas vaginalis infection in England: an epidemiological study using electronic health records from sexually transmitted infection clinics, 2009–2011. Epidemiol Infect. 2014; 142: 1678–1687. 3 Public Heath England October 2020 (https://www.gov.uk/ government/statistics/sexually-transmitted-infections-stis- annual-data-tables. Last accessed 16 March 2021.) 4 Hesseltine, H. Experimental human vaginal Trichomoniasis. J Inf Dis. 1942; 71: 127. 5 Sherrard, J., Ison, C., Moody, J. et al. United Kingdom National Guideline on the Management of Trichomonas vaginalis 2014. Int J STD AIDS. 2014 Jul; 25(8): 541–549. 6 Levi, M.H., Torres, J., Pina, C. et al. Comparison of the InPouch TV culture system and Diamond’s modified medium for detection of Trichomonas vaginalis . J Clin Microbiol. 1997; 35: 3308–3310. 7 Gelbart, S., Thomason, J., Osypowski, P. et al. Comparison of Diamond’s modified medium and Kupferberg for the detection of Trichomonas vaginalis . J Clin Microbiol. 1989; 27: 1095–1096. 8 Krieger, J.N., Tam, M.R., Stevens, C.E. et al. Diagnosis of Trichomoniasis: Comparison of conventional wet mount examination with cytological studies, cultures and monoclonal antibody staining of direct specimens. JAMA. 1988; 259: 1223 – 1227. 9 Laga, M., Manoka, A., Kivuvu, M. et al. Non ulcerative sexually transmitted diseases as risk factors for HIV-1 transmission in women: Results from a cohort study.
eBook - ePub- William J. Ledger, Steven S. Witkin(Authors)
- 2017(Publication Date)
- CRC Press(Publisher)
3 MICROBIOLOGYTrichomonas vaginalis is a flagellated, singlecell, eukaryotic, protozoan parasite that resides extracellularly in the human female lower genital tract and the male urethra. Following its sexual transmission, the free swimming trophozoite form undergoes a morphological transition to an amoeboid form that strongly adheres to epithelial cells. T. vaginalis infection is the leading nonviral sexually transmitted infection worldwide. Its prevalence has been estimated to approach that of Chlamydia trachomatis, Neisseria gonorrhoeae, and syphilis combined.4 This is probably an under-estimate since at least one-third of T. vaginalis infections in women and most infections in men are without distinguishing symptoms. In symptomatic women, T. vaginalis is a common cause of mucopurulent cervicitis and vaginitis.5 There is no relation between the number of organisms present in the vagina and clinical signs and symptoms. This indicates that individual host immune and genetic factors, as well as the composition of the vaginal microbiota, influence the consequences of a T. vaginalis infection.The genome of T. vaginalis is highly unusual.6 The organism is haploid and has six chromosomes. Its DNA content (approximately 160 MB) is much higher than that of other unicellular parasites. Another unique attribute of T. vaginalis DNA is that one-fourth of the genome is composed of repetitive sequences that apparently do not code for any proteins. There are two major subtypes of T. vaginalis, TV1 and TV2,7 based upon genome diversity. Surprisingly, T. vaginalis appears to be most closely related to parasites found in birds,8 suggesting that, in times past, it jumped from birds to humans. The organism also does not have mitochondria and instead contains a structure called a hydrogenosome.9
eBook - PDFMicrobiology
Principles and Explorations
- Jacquelyn G. Black, Laura J. Black(Authors)
- 2018(Publication Date)
- Wiley(Publisher)
This pH is caused by a community of Mycoplasma bacteria. It was originally thought that the Mycoplasma community ex- isted first, and the Trichomonas moved in secondarily. It was now been found that the Trichomonas move in first, and like “farmers” cultivate the Trichomonas that are in some way beneficial to themselves. The symptoms of Trichomoniasis are intense itching and a copious white discharge, especially in females, having the consistency of raw egg white. Males are usually asymptomatic, but male partners of infected women must also be treated to prevent reinfection. Trichomonas can survive on towels, sheets, and underwear and can be transmitted by sharing. Trichomoniasis is diagnosed by microscopic exami- nation of smears of vaginal or urethral secretions and treated with metronidazole (Flagyl) and restoration of normal vaginal pH in women. Flagyl cannot be used dur- ing pregnancy because it causes abortions, but it is impor- tant to get rid of the infection before delivery to prevent infecting the infant. A vinegar douche usually is effective. Trichomonas infection can also cause early rupture of membranes and premature delivery. The effects of different species of Trichomonas il- lustrate the extreme variation in the degree of damage but women who have had TSS can reduce their risk of recurrence by ceasing to use tampons. Although infrequent changing of superabsorbent tampons accounted for most cases of TSS, the contracep- tive sponge caused some, and for this reason was with- drawn from the market. Parasitic Urogenital Diseases Trichomoniasis Although Trichomoniasis is transmitted primarily by sexual intercourse, it is discussed here because of its Warning: Important Information about Toxic Shock Syndrome (TSS) If you use tampons frequently, you are probably used to throwing out the insert that is found in practically every box.
eBook - PDFOffice Gynecology
A Case-Based Approach
- David Chelmow, Nicole W. Karjane, Hope A. Ricciotti, Amy E. Young(Authors)
- 2019(Publication Date)
- Cambridge University Press(Publisher)
Trichomonas vaginalis as a cause of perinatal morbidity: a systematic review and meta-analysis. Sex Transm Dis 2014;41(6):369–376. 5. Nye MB, Schwebke JR, Body BA. Comparison of APTIMA Trichomonas vaginalis transcription-mediated amplification to wet mount microscopy, culture, and polymerase chain reaction for diagnosis of Trichomoniasis in men and women. Am J Obstet Gynecol 2009;200:188.e1–188.e7. 6. Centers for Disease Control and Prevention. Sexually Transmitted Diseases Treatment Guidelines, 2015. MMWR Recomm Rep 2015;64(No. RR- 3):1–137. 7. Vaginitis. American College of Obstetricians and Gynecologists Practice Bulletin No. 72. Obstet Gynecol 2006;107 (5):1195–1206. 8. Gülmezoglu AM, Azhar M. Interventions for Trichomoniasis in pregnancy. Cochrane Database Syst Rev 2011, Issue 5. Art. No.: CD000220. DOI:10.1002/14651858.CD000220. pub2. 9. Howe K, Kissinger PJ. Single-dose compared with multidose metronidazole for the treatment of Trichomoniasis in women: a meta-analysis. Sex Transm Dis 2017;44:30–35. 10. duBouchet L, McGregor JA, Ismail M, McCormack WM. A pilot study of metronidazole vaginal gel versus oral metronidazole for the treatment of Trichomonas vaginalis vaginitis. Sex Transm Dis 1998;25 (3):176–179. 11. Sheehy O, Santos F, Ferreira E, Berard A. The use of metronidazole during pregnancy: a review of evidence. Curr Drug Saf2015;10(2):170–179. Section 2: Vaginal Discharge and Sexually Transmitted Infections 38 CASE 13 A 16-Year-Old Adolescent Requesting Confidential Treatment for Chlamydia Exposure (Understanding State Laws Regarding Minors and Resources) Kavita Shah Arora History of Present Illness A 16-year-old, gravida 0, para 0, adolescent with last menstrual period three weeks ago presents to the office requesting treat- ment for chlamydia exposure. She is a new patient to the office, is unaccompanied by a parent/guardian, and is requesting confidential treatment.
eBook - PDF- Robert Crooks, Karla Baur, Laura Widman, , Robert Crooks, Karla Baur, Laura Widman, (Authors)
- 2020(Publication Date)
- Cengage Learning EMEA(Publisher)
Men: Usually asymptomatic but may have itching or reddening of the penis and burning during urination. Trichomoniasis The protozoan parasite Trichomonas vaginalis is usually passed through intercourse. Women: White or yellow vaginal discharge with unpleasant odor; vulva is sore and irritated. Men: Usually asymptomatic but may have urethral discharge, urge to urinate frequently, or painful urination. Pubic Lice (“crabs”) Pubic louse is spread through body contact or through shared clothing or bedding. Persistent itching. Lice are visible and can be located in pubic or other body hair. Scabies Highly contagious. Can be passed by close physical contact (sexual and nonsexual). Small bumps and a red rash that itch intensely (especially at night). Human Immunodeficiency Virus (HIV)/Acquired Immunodeficiency Syndrome (AIDS) Virus that attacks the immune system. Transmitted primarily through blood, semen, and vaginal fluids, but also breast milk, pre-seminal fluid, and rectal fluid. Common symptoms include fever, night sweats, weight loss, chronic fatigue, swollen lymph nodes, diarrhea and/ or bloody stool, atypical bruising or bleeding, skin rashes, headache, chronic cough, and a whitish coating on the tongue or throat. At a Glance • TABLE 15.1 Common Sexually Transmitted Infections: Transmission and Symptoms (Continued) Copyright 2021 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. 428 CHAPTER 15 help to confide in a close friend or family member to practice what you would like to say to a partner.
No longer available |Learn more- Crooks/Baur, Robert Crooks, Karla Baur(Authors)
- 2016(Publication Date)
- Cengage Learning EMEA(Publisher)
Can be passed through sexual interaction. Women: White, “cheesy” discharge, irritation of vaginal and vulval tissues. Men: Usually asymptomatic but may have itching or reddening of the penis and burning during urination. Vaginal suppositories or topical cream, such as clotrimazole and miconazole. Oral fluconazole or itraconazole. Trichomoniasis The protozoan parasite Trichomonas vaginalis is usually passed through sexual contact. Women: White or yellow vaginal discharge with unpleasant odor; vulva is sore and irritated. Men: Usually asymptomatic but may have urethral discharge, urge to urinate frequently, or painful urination. One dose of metronidazole (Flagyl or oral tinidazole) for women and men. Pubic lice (“crabs”) Pubic louse is spread through body contact or through shared clothing or bedding. Persistent itching. Lice are visible and can be located in pubic or other body hair. Prescription or over-the-counter medications (lotions or creams) applied to all affected areas. Scabies Highly contagious. Can be passed by close physical contact (sexual and nonsexual). Small bumps and a red rash that itch intensely (especially at night). Topical scabicide applied from neck down to toes. Acquired immuno-deficiency syndrome (AIDS) Blood, semen, and vaginal fluids are the major vehicles for transmitting HIV (which attacks the immune system). Passed primarily through penile– vaginal, oral–genital, oral–anal, or genital–anal contact or by needle sharing among injection drug users. Varies with the types of opportunistic infections or cancers that can afflict an infected person. Common symptoms include fever, night sweats, weight loss, chronic fatigue, swollen lymph nodes, diarrhea and/or bloody stool, atypical bruising or bleeding, skin rashes, headache, chronic cough, and a whitish coating on the tongue or throat. Commence treatment with a combination of antiretroviral drugs (HAART) when CD4 count is significantly low.
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