Trichomonas vaginalis is a protozoan with flagella that can survive in an anaerobic (oxygen-free) environment. It is the most common pathogenic protozoan infection in humans in developed countries, and infection rates are the same in men and women. Women also exhibit symptoms, while men do not. The World Health Organization (WHO) reports a global infection rate of 180 million new cases each year.
Trichomonas vaginalis is one of the most common sexually transmitted pathogens, with millions of cases recorded each year. In most states and many nations, physicians and other health care professionals are expected to disclose sexually transmitted diseases (STDs), although this is not always the case. As a result, the prevalence could be much higher than published, and a large number of cases go undiagnosed. This organism is present in both male and female urogenital tracts, and humans are the only hosts at this time. This infection is also associated with the involvement of other sexually transmitted diseases, most notably gonorrhea. As previously stated, this organism does not have a cyst stage and is susceptible to drying out and not surviving to be transmitted to others when contained in body fluids outside the body, though a few instances have been reported to be transmitted non-sexually.
Morphology of Trichomonas vaginalis Trophozoite
In females, the trophozoite is typically found in the urine or vaginal discharge, which allows the diagnosis to be made. The trophozoites can also be found in urine and prostatic secretions in men. The species have four anterior flagella, and the cell membrane undulates in those that are strongly motile. Dead or dying trophozoites are more difficult to identify visually and can be mistaken for white blood cells. As a result, the specimen should be read microscopically as soon as possible after collection, as the viability of the organism diminishes rapidly in the open air and light. A stained specimen will reveal a pear-shaped cell with an axostyle, which is a centrally located line that runs the length of the organism. One nucleus is usually evident at the anterior end, and the organism ranges in size from 5 to 19 m. This is also beyond the range of white blood cells, making it possible to overlook a Trichomonas vaginalis infection when the specimen is more than a few minutes old and contains white blood cells. Another essential class of pathogenic flagellates is those occurring primarily in the blood and tissues.
Symptoms of Trichomoniasis
The infected person can experience
- significant inflammation of the vaginal mucosa’s surrounding tissues
- yellowish discharge with lesions in some cases.
- Men may be asymptomatic, or they may experience prostate and upper urogenital tenderness and swelling.
Life Cycle of Trichomonas vaginalis
The trophozoite stage, which is the only one found in T. vaginalis infections, is motile and relatively easy to discern in urine samples and vaginal secretions. They may, however, be confused with white blood cells, especially if the organisms are sluggish due to temperature, light, or other adverse environmental conditions. Due to the difficulty of preserving Trichomonas species viability for microscopic analysis and possibly culture, a routine universal transport medium may be suggested, and a number of these are commercially available. Despite the presence of significant numbers of species in vaginal discharges, 50% of infected women are asymptomatic. Men are normally asymptomatic carriers, but they can develop a milky discharge and nonspecific urethritis.
Trichomoniasis Disease Transmission
The severity of the symptoms varies from mild to non-existent. Women, in particular, may be asymptomatic but have the ability to spread the organism to others. Since the disease is highly infectious, all partners in a sexual relationship should be treated, since reinfection will occur on a regular basis while one partner is asymptomatic.
Laboratory Diagnosis Of Trichomonas vaginalis
T. vaginalis infection is diagnosed by direct examination of motile trophozoites. Since the species could be confused for white blood cells, the sample should be tested as soon as it is received. All bodily fluids, including urine, vaginal discharges, and urethral secretions, should not be allowed to cool until inspection. A liquid microbiological media is often used to culture the organism, and permanent stained slides are possible, but they produce a variety of false positive and false negative results. Some serological tests are available, but they are not commonly used.
Treatment and Prevention Of Trichomoniasis
Metronidazole is the recommended treatment. Avoiding casual sex with spouses whose background is unknown is how prevention is achieved. It is critical to treat and diagnose men who are asymptomatic and can easily spread the organism as soon as possible.