Trichomonas vaginalis trichomoniasis is a common sexually transmitted infection that can cause symptoms such as yellow-green vaginal discharge in women, while men are often asymptomatic. The infection is associated with serious health concerns, including an increased risk of HIV transmission and complications like infertility. Diagnosis typically involves microscopic examination, and treatment with metronidazole is effective for both genders.

1. Trichomonas vaginalis

2. Trichomoniasis is a sexually transmitted infection caused
by the protozoa Trichomonas vaginalis.
Women with trichomoniasis may experience various
symptoms, including a yellow-green vaginal discharge
and vulvar irritation, or they may be asymptomatic.
Men with trichomoniasis are frequently asymptomatic.
Trichomoniasis

3. The high incidence of trichomoniasis worldwide, its contribution to
poor health outcomes, and its co-infection with other sexually
transmitted infections make trichomoniasis a compelling public
health concern.
Notably, T vaginalis infection is believed to increase the risk of HIV
transmission.
Trichomoniasis is also associated with adverse pregnancy
outcomes, infertility, post-operative infections, and cervical
neoplasia.
Trichomoniasis

4. Worldwide, the annual incidence of trichomoniasis is about
170 million cases. The incidence of trichomoniasis in
Europe is similar to that in the United States. In Africa,
the prevalence of trichomoniasis may be much higher.
Epidemiology

5. The infection is highly associated with the presence
of other sexually transmitted infections, including
gonorrhea, chlamydia, and HIV.
In men, complications of untreated trichomoniasis
include prostatitis, epididymitis, urethral stricture
disease, and infertility. Infertility may result from a
decreased sperm motility and viability.
Epidemiology

6. T vaginalis is approximately the size of a white blood cell
(about 10 μm in diameter), although its size may vary
with physical conditions. Its flagellum allows it to move
around vaginal and urethral tissues.
T vaginalis directly damages the epithelium, leading to
micro-ulcerations of inhabited tissues, increasing the risk
of HIV transmission.
Pathophysiology

7. Symptoms of trichomoniasis typically occur after an
incubation period of 4-28 days.
In women, T vaginalis is isolated from the vagina,
cervix, urethra and bladder.
In men, the organism is found in the anterior urethra,
external genitalia, prostate, epididymis, and semen.
Pathophysiology

8. Women
Women with trichomoniasis frequently report a frothy yellowish-green
vaginal discharge, abnormal vaginal odor, vulvovaginal itching and
soreness, dyspareunia (pain during sexual intercourse), and
dysuria (pain during urination). Cervicitis due to
trichomoniasis is characterized by 2 major signs—purulent
discharge in the endocervical canal and easily induced
endocervical bleeding.
T vaginalis infection is one of the top 3 causes of vaginitis. Vaginitis
is usually characterized by vaginal discharge, which may be
Clinical Symptoms

9. Men
Trichomoniasis symptoms in men range from none to
urethritis complicated by prostatitis. Nongonococcal
nonchlamydial urethritis is the most common symptom
reported by men with trichomoniasis.
Symptoms of urethritis include discharge, dysuria, and
urethral pruritus. The discharge may be purulent to
mucoid in character.
Clinical Symptoms

11. All the trichomonads are morphologically similar, having
a pear-shaped body 7- 23 μm long, a single anterior
nucleus, three to five forward-directed flagella, and a
single posteriorly directed flagellum that forms the
outer border of an undulating membrane.
Structure

12. Trichomonads have the simplest kind of
protozoan life cycle, in which the organism
occurs only as a trophozoite. Division is by
binary fission. Because there is no resistant
cyst, transmission from host to host must be
relatively direct.
Life Cycle

13. Life Cycle

14. A wet mount preparation of discharge from the patient should be
examined microscopically as a first step in diagnosing T vaginalis
infection. The presence of typical pear-shaped trophozoites,
usually 7 to 23 μm in length, with "bobbling“ motility and, on
careful examination, the wavelike movement of the undulating
membrane, are usually sufficient to identify T vaginalis.
Material that is negative by wet mount examination should be cultured
because culturing is a considerably more sensitive, although time-
consuming, method of diagnosis.
Diagnosis

15. Metronidazole is effective in both males and females.
Vinegar douche may be useful.
Personal hygiene and the use of condoms are helpful.
Treatment & Control

16. Summary