Laboratory Diagnostic of Trichomonas vaginalis infection

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Laboratory Diagnostic of Trichomonas vaginalis infections

Trichomonas vaginalis infections occur worldwide.The main mode of transmission of Trophozoites Trichomonas vaginalis  is sexual intercourse.They can also migrate through the birth channel of a mother and infect the unborn child.It is known that Trichomonas vaginalis is an std parasite and  is transmitted via contaminated toiletries or underwear under optimal conditions.This mode of transmission is rare, however.The sharing of shower supplies and shared bathing are also potentially infectious routes.Trichomonas vaginalis trophozoites, which are naturally hardy and resistant to environmental changes, have been known to survive for several hours in urine, on wet sponges and on moist towels, as well as in water for up to 40 minutes.

Morphology of Trichomonas vaginalis


Although typical Trichomonas vaginalis trophozoites can reach a length of up to 30 μm, the average length is 8 to 15 μm.The trophozoites may appear to be ovoid, round or pearlike.Rapid jerky motility is achieved with the help of the four to six flagella of the organism, all of which originate from the anterior end.Only one of the flagella extends posteriorly.It may be difficult to find the flagella on the specimen preparations.The characteristic undulating membrane is short, relatively speaking, extending only half of the length of the body.The single nucleus is ovoid, undescribed and not visible in imperfect preparations.The single nucleus is ovoid, nondescript, and not visible in unstained preparations.Trichomonas vaginalis trophozoites have an easily recognizable axostyle that frequently curves around the nucleus and later extends beyond the body.Along the axostyle, granules can be seen.

Trichomonas vaginalis trophozoite
Trichomonas vaginalis trophozoite


There is no known stage of Trichomonas vaginalis cyst.

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Life Cycle of Trichomonas vaginalis

In infected women(trichomoniasis female), Trichomonas vaginalis trophozoites reside on the mucosal surface of the vagina.The growing trophozoites multiply by binary longitudinal fission and feed on local bacteria and leukocytes.Trichomonas vaginalis trophozoites thrive in a slightly alkaline or slightly acidic pH environment, such as in an unhealthy vagina.

The most common site of Trichomonas vaginalis infection in males is the prostate gland region and the urethra epithelium.The detailed life cycle is unknown in the male hosts.

Life cycle of Trichomonas vaginalis
Life cycle of Trichomonas vaginalis

Clinical symptoms of Trichomonas vaginalis infections

Asymptomatic Carrier State

Asymptomatic cases of Trichomonas vaginalis occur most frequently in men

Persistent Urethritis

Persistent or recurrent urethritis is the condition experienced by symptomatic men as a result of Trichomonas vaginalis.Severe cases of infection may involve the seminal vesicles, higher parts of the urogenital tract and the prostate.Severe infection symptoms include increased tender prostate, dysuria, nocturia, and epididymitis.These patients often release a thin, white urethra discharge containing the trophozoites of Trichomonas vaginalis

Persistent Vaginitis (trichomonal vulvovaginitis)

Persistent vaginitis (trichomoniasis in women), found in infected women, is characterized by greenish – yellow vaginal fluid discharge (trichomoniasis discharge)  after 4 to 28 days of incubation.Vaginal acidity during and immediately after the menstrual period is most likely to exacerbate the symptoms.There may also be burning, itching, and chaffing.Red punctate lesions may occur during examination of the vaginal mucosa of infected women.The involvement of the urinary tract, dysuria and increased urination frequency are among the most common symptoms.Cystitis is less prevalent, but may occur

Infant Infections

Trichomonas vaginalis has been recovered from infants with both respiratory and conjunctivitis infections.These conditions were most likely caused by Trichomonas vaginalis trophozoites migrating through the birth canal and/or during vaginal delivery from an infected mother to the infant.

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Discharges from trichomonas infection
Discharges from trichomonas infection

Laboratory Diagnosis of Trichomonas vaginalis infections

Trichomonas vaginalis trophozoites can be recovered in spun urine, vaginal discharges, urethral discharges and prostatic secretions using standard processing methods.Although permanent stains can be carried out, in many cases it is preferable to examine saline wet preparations.

In addition to the quick examination of saline wet preparations, the practitioner can easily observe the active motility of the organism and the other typical characteristics, the testing can be carried out in a relatively short time.Also available are phase contrast microscopy, papanicolaou (Pap) smears, fluorescent stains, monoclonal antibody tests, enzyme immunoassays and cultures.

For Trichomonas vaginalis detection, a DNA – based test has been developed using Affirm VPIII (BD Diagnostics, Sparks, MD). This test method’s sensitivity and specificity is much greater than with standard processing methods.

Another diagnostic tool currently used by the laboratories is the culture system InPouch TV (BioMed Diagnostics, White City, OR).This method can be used with women’s vaginal swabs, men’s urethral swabs, urine sediments, and semen.This method requires incubation time and takes up to three days to determine the result.

Treatment of Trichomonas vaginalis

With few exceptions, std trichomoniasis antibiotic like metronidazole (Flagyl) is the treatment of choice for Trichomonas vaginalis infections . Since this parasite is sexually transmitted, it is recommended to treat all sex partners.

Prevention and Control of Trichomonas vaginalis

The first step in preventing and controlling Trichomonas vaginalis infections is to prevent unprotected sex.Furthermore, the quick diagnosis and treatment of asymptomatic men is important.Although the risk of contracting Trichomonas vaginalis is relatively low, it is recommended to avoid sharing shower equipment and shared bathing, as well as close contact with potentially infectious underwear, toiletries, moist towels and wet sponges.

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Notes of Interest and New Trends

Trichomonas vaginalis infections are usually regarded as a nuisance and not a major pathogenic process.

There is evidence that Trichomonas vaginalis is associated with carcinoma of the cervix.

Pap smear with Trichomonas vaginalis
Pap smear with Trichomonas vaginalis

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About the Author: Arthur Westmann

DEFFE ARTHUR (AMOEBAMANN) is the founder and author of MLTGEEKS and MLTEXPO.He’s from Cameroon and is currently a Final year State Medical Laboratory Technician (MLT MA). Beyond lab works, he’s a passionate internet user with a keen interest in web design and blogging. Furthermore He likes traveling, hanging around with friends and social networking to do in his spare time.