Trichomonas

Question 1

What is the habitat and transmission of Trichomonas v.

Answer 1

Trichomonas vaginalis resides in the vagina or male urethra. It is sexually transmitted.

Males are often asymptomatic.

It is capable of living at room temp for several hours in moisture so it is theoretically possible to be non-sexual transmitted.

Maternal transmission to newborns during birth is also possible.

Question 2

Trichomonas vaginalis clinical presentation

Question 3

Trichomonas vaginalis morphology

Answer 3

Exists only as a trophozoite

Slightly larger than an RBC, about 7-9uM, oval/pear shaped

Has five total flagella four emrging from the apical point extending forwards, and one wraps straight backward attached to the surface of the protozoan, and ends in a barb-like axostyle pointing backwards, which may aid in attachment.

Question 4

Trichomonas vaginalis clinical presentation

Answer 4

Clear/White/Yellow/Green vaginal discharge with foul odor.

Causes vaginitis and severe cervicitis, which gets so swollen it is coined strawberry cervix. It also causes burning pain and itching of the vagina/cervix, even unrelated to urination.

Urethritis and painful urination.

Men are usually asymptomatic, but may have urethritis or prostatitis.

Question 5

Diagnosing Trichomonas

Answer 5

Make a wet mount of the vaginal smear.

It will contain motile trophozoites. (Gardenerella shows clue cells, and Candida shows pseudohyphae and budding yeast cells)

Test the pH of the vaginal fluid. It will be alkalinized, increased to 4.5pH and above.

Question 6

Trichomonas treatment

Answer 6

Treat with Metronidazole

Importantly, must treat both sexual partners even if the male is asymptomatic.