Trichomonas Vaginalis (FINAL)

TRICHOMONAS
VAGINALIS
BY: RIZA REGUNDA DM40TH BATCH

CLASSIFICATION
Domain: Eukarya Common names: trich, vaginitis,
ureitis
Kingdom: Protista
Phylum: Metamonada Scientific: Trichomonas vaginalis
Class: Parabasilia
Order: Trichomonadida
2
BACKGROUND INFORMATION
• Trichomoniasis is a sexually transmitted infection (STI) caused by the motile
parasitic protozoan Trichomonas vaginalis.
• It is one of the most common STIs, both in the United States and worldwide.
• The high prevalence of T vaginalis infection globally and the frequency of
coinfection with other STIs make trichomoniasis a compelling public health
concern.
• Research has shown that T vaginalis infection is associated with an increased risk
of infection with several STIs, including gonorrhea, human papillomavirus (HPV),
herpes simplex virus (HSV), and, most importantly, HIV
3
MORPHOLOGY
• Single-celled
• Pear shaped
• 7 – 23 in length • 4 flagella extend

anteriorly • 1 flagellum extends
posteriorly along the cell membrane
to form an undulating membrane.
4
MORPHOLOGY
• Teardrop shaped protest

that can grow between 5
and 20 µm wide.
• Costa, a rigid cord

attaches the undulating
membrane to the cell
membrane and gives the
undulating membrane
support
5
MORPHOLOGY
• Axostyle runs down the

middle of the body & ends
in a pointed tail like
etremity •
• Round nucleus in the

anterior portion
6
7
HABITAT AND INCUBATION
PERIOD
• Incubation Period is typically 5
to 28 days
• Trichomonas vaginalis is
pathogenic in the genitourinary
tract
• In women, it lives in the vagina
and the Skene's glands (of the
urethra)
• In men, it lives in the urethra
8
HABITAT AND INCUBATION
PERIOD
• Multiplies when vaginal

conditions become more
basic than usual (normal pH
is 3.8 to 4.2)
• No known cystic form
• May survive in a host for 2+
years
9
• Acquires nutrients through cell
membrane transport and
NUTRITION phagocytosis
• Bacteria, archea, and even
parts of the vagina wall are
consumed.
12
Life cycle
9
MODE OF TRANSMISSION
Whereas women can acquire

trichomoniasis from men or women,
men usually contract infection only
from women.
MALE/FEMALE FEMALE/FEMALE
INTERCOURSE INTERCOURSE
14
SIGNS AND SYMPTOMS
Men:
• Usually symptomatic
• Itching or irritation inside the penis;(rare cases)
• Burning after urination or ejaculation;
• Discharge from the penis.
15
SIGNS AND SYMPTOMS
Women:
• Show symptoms of being infected between five and 28 days
after exposure
• Itching, burning, redness of the genitals;
• Discomfort with urination;
• Fishy smell, frothy, discharge, ranging from green to yellow to
gray
• Sores will sometimes be present as well, from the T. vaginalis'
bab-wire like axostyles.
• Having trichomoniasis can make it feel unpleasant to have
sex. 16
SIGNS AND SYMPTOMS
Pregnant:
• Preterm delivery
• Low birth weight
• Increased mortality as well as predisposing to HIV infection,
AIDS and cervical cancer
17
SIGNS AND SYMPTOMS
Also reported in the urinary tract, fallopian tubes, and pelvis and
can cause
• Pneumonia
• Bronchitis
• Oral lesions
18
LABORATORY DIAGNOSIS
1. Microscopy
 from vaginal or cervical samples and from urethral or prostatic secretions.

 T. vaginalis trophozoites, which are identified by their jerky and twitching
motility,
 large numbers of polymorphonuclear (PMN) cells and squamous epithelial
cells.
 Bacteria flora consisting of rods or coccobacilli.
19
2. Culture
• Gold standard
• Most sensitive
• Media – Diamond’s, Lash & Kupferberge
• Media contains yeast extract, horse serum & antibiotics
• Observed for 7 days
• Culture usually positive after 48 hrs
• Done in patients with suspected Trichomoniasis but wet mount negative
20
3. Antigen detection
 Enzyme-linked immunosorbent assay (ELISA)

 ELISA using a monoclonal antibody specific for a 65-k Da surface
polypeptide of T. vaginalis is a very specific and sensitive method for
detection of the parasite in vaginal secretion.
21
4.Serodiagnosis
 It is non-specific test and has low sensitivity.

 These are of limited value in the diagnosis of trichomoniasis in individual
cases.
5. Molecular diagnosis
 DNA probes: the DNA probes have been used for identification of T.
vaginalis DNA in vaginal and urethral secretions.
22
6. Other Test
 Determination of vaginal pH:
 Vaginal pH is usually above 4.5 in trichomoniasis or in bacterial
vaginosis but not in candidiasis.
 The vaginal pH is measured by Nitrazine paper method.
 Whiff test or Amine odor test:

 This test is positive in trichomoniasis and also in bacterial
vaginosis.
23
EPIDEMIOLOGY
• Trichomonas vaginalis is the most prevalent nonviral sexually trnansmitted
infection, causing 3.7 million infections annually among men and women in
the United States.
• Among adolescents, an estimated 2.8% of girls and 1.7% of boys are

infected.
• Prevalence of infection increases with age, and the infection affects a

disproportionately high percentage of black women.
24
EPIDEMIOLOGY
• High-risk groups include incarcerated populations and sexually transmitted
disease clinic patients.
• T. vaginalis infection is associated with preterm delivery and an increased

risk of human immunodeficiency virus (HIV) infection.
25
MEDICATION
Metronidazole or Tinidazole
 Metronidazole – highly effective
 MTZ or TNZ 2 gm orally in a single dose as the

recommended regimens
26
Treatment among pregnant and
lactation women:
Mmetronidazole
2 g orally in a single dose
27
PREVENTION & CONTROL
 Detection & treatment of cases – both partners

 Avoidance of sexual contact with infected partners
 Use of condoms
 Also, wait 7- 10 days after you and your partner have been treated to
have sex again.
 Get checked again if your symptoms come back.
28
PREVENTION & CONTROL
 counsel symptomatic pregnant women with trichomoniasis

regarding the potential risks for and benefits of treatment and
about the importance of partner treatment and condom use in
the prevention of sexual transmission.
 Be in a long-term mutually monogamous relationship with a

partner who has been tested and has negative STD test
results.
29
• https://www.scribd.com/doc/137167378/Lifecycle-Trichomonas-
Vaginalis?fbclid=IwAR3cnCzcIiIPm_V5bGKt4b806tfwS9QZXh_-NqmOetfgmf9f2y3q83o1pns
• https://www.cdc.gov/std/trichomonas/stdfact-
trichomoniasis.htm?fbclid=IwAR1WtwRlmaKFpldhyxNouMH_qy2Jmxnk2zhXSVMBA1-lI35cqQvbhGnWXDo
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2095007/
• http://www.antimicrobe.org/Lifecycle/b65lc.asp
• https://www.scribd.com › doc › Life...
• https://web.stanford.edu/group/parasites/ParaSites2005/Trichomoniasis/epidemiology.htm
• https://www.cdc.gov/std/trichomonas/stdfact-
trichomoniasis.htm?fbclid=IwAR1WtwRlmaKFpldhyxNouMH_qy2Jmxnk2zhXSVMBA1-lI35cqQvbhGnWXDo
30
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TRICHOMONAS

BY: RIZA REGUNDA DM40TH BATCH

Phylum: Metamonada Scientific: Trichomonas vaginalis

• 7 – 23 in length • 4 flagella extend

• Teardrop shaped protest

• Costa, a rigid cord

• Axostyle runs down the

• Round nucleus in the

• Multiplies when vaginal

Whereas women can acquire

 from vaginal or cervical samples and from urethral or prostatic secretions.

 Enzyme-linked immunosorbent assay (ELISA)

 It is non-specific test and has low sensitivity.

 Whiff test or Amine odor test:

• Among adolescents, an estimated 2.8% of girls and 1.7% of boys are

• Prevalence of infection increases with age, and the infection affects a

• T. vaginalis infection is associated with preterm delivery and an increased

 Metronidazole – highly effective

 MTZ or TNZ 2 gm orally in a single dose as the

 Detection & treatment of cases – both partners

 counsel symptomatic pregnant women with trichomoniasis

 Be in a long-term mutually monogamous relationship with a

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