Trichomonas Vaginalis Vaginitis
William J. Ledger, Steven S. Witkin in Vulvovaginal Infections, 2017
The level of physician concerns about the possibility of a symptomatic T. vaginalis vaginal infection varies with the history of the patient presenting for care. A suspicion of a possible Trichomonas infection should be high in a sexually active patient with the recent onset of new symptoms. These women are uncomfortable, with an excessive, irritating vaginal discharge and often a new awareness of lower genital tract odor. Physicians need to inquire if the patient has had a recent sexual encounter with a male partner and if she had been exposed to that male’s ejaculate. These patients should be queried about recent vaginal medication treatment, either vaginal antibiotic creams, residuals left over from past treatments, or over-the-counter vaginal antifungal medications. The patient’s response to these self-medication attempts should be noted.
Infections
Anne Lee, Sally Inch, David Finnigan in Therapeutics in Pregnancy and Lactation, 2019
Vaginitis due to the protozoan Trichomonas vaginalis is a common sexually transmitted disease. Infection classically presents with green-yellow frothy vaginal discharge, irritation of the vulval and urethra with pain and itching, painful sexual intercourse, and dysuria. Vaginal discharge is the most frequent complaint, but the classical appearance is only present in approximately 10% of women and many women have asymptomatic infection.2 The diagnosis is usually made on the history and examination with microscopic examination of a wet preparation of vaginal secretions or isolation of the organism on culture. There is a lack of data on whether infection has an adverse effect on pregnancy.91 Treatment is usually only recommended for symptomatic infection. Metronidazole (see bacterial vaginosis) is effective, with microbiological cure rates of more than 90% at seven days. It is recommended that partners also receive treatment.92 Other sexually transmitted diseases frequently co-exist with trichomonas infection and should be excluded in all cases.
The Ecology of Parasitism
Eric S. Loker, Bruce V. Hofkin in Parasitology, 2015
Of course a tragic hallmark of HIV/AIDS that became apparent early on is its immunosuppressive effects, mediated by depletion of CD4+ T lymphocytes. Immunosuppression facilitates opportunistic infections with other viruses, bacteria (including M. tuberculosis), fungi, protozoans (including malaria), and helminths. Conversely, it has also been speculated that chronic helminth infections, by virtue of skewing the immune system toward a Th-2 cytokine profile and up-regulating CCR5 (a co-receptor used by HIV to enter cells), might greatly favor progression of both HIV and TB and undermine eventual attempts to vaccinate against them. Damage to the female urogenital system by the helminth Schistosoma haematobium may facilitate heterosexual transmission of HIV and infection with Schistosoma mansoni may favor reactivation of latent tuberculosis. Infections with Trichomonas vaginalis are associated with long-term infections with human papilloma virus (HPV) and increased risk of acquiring HIV. Furthermore, T. vaginalis itself is frequently colonized by Mycoplasma hominis, an intracellular bacterium that can also colonize urogenital mucous membranes. This relationship seems to be mutually beneficial and T. vaginalis serves as a Trojan horse for transmission of M. hominis into a new human host. The close association of these two organisms is reminiscent of the suspected exploitation of the eggs of the human pinworm (Enterobius vermicularis) by the diarrhea-causing protozoan Dientamoeba fragilis for its transmission. These kinds of dependencies of course result in the two parasites involved being positively associated in the human host.
Inhibition of the β-carbonic anhydrase from the protozoan pathogen Trichomonas vaginalis with sulphonamides
Published in Journal of Enzyme Inhibition and Medicinal Chemistry, 2021
Linda J. Urbański, Andrea Angeli, Vesa P. Hytönen, Anna Di Fiore, Giuseppina De Simone, Seppo Parkkila, Claudiu T. Supuran
Trichomonas vaginalis is a protozoan parasite responsible for trichomoniasis, one of the most frequent non-viral sexually transmitted diseases in humans1,2. Treatment of this disease remains almost exclusively based on just one class of drugs, 5-nitroimidazoles (with two available agents, metronidazole and tinidazole), and resistance to these agents is on the rise worldwide3,4. Trichomoniasis may cause a variety of symptoms, from mild to severe, but a large fraction (10–50%) of infected women show no symptoms, and 5–15% of cases may remain undetectable upon examination1,2. Furthermore, the majority of infected men are totally asymptomatic, making the diagnosis of this disease particularly challenging1,2. T. vaginalis infection may facilitate or worsen other critical pathologies, such as HIV-infection5 or even prostate cancer6. As a consequence, research on novel drug targets for fighting trichomoniasis has seen an increased interest7–11.
A profile of the cobas® TV/ MG test for the detection of Trichomonas vaginalis and Mycoplasma genitalium
Published in Expert Review of Molecular Diagnostics, 2020
Barbara Van Der Pol
Although the assay received clearance from the FDA in 2019, the data from the US clinical study have not yet been published. However, the instruction for use that accompanies the cleared assay provides the which was reviewed by the FDA and some of those data have been presented. In the clinical study, results from the cobas TV/MG assay were compared to different assays for TV performance estimation than those used to estimate the performance of the MG assay since at the time of study inception there were limited options for obtaining both trichomonas and mycoplasma molecular diagnostic results. Detection of trichomonas was compared to the ATV assay and culture; a positive result by either of these tests defined infection status. The estimated sensitivity of the assay ranged from 94.7% to 99.4% for female specimen types and 100% from male urine. Specificity was ≥96.8% for all sample types (male and female). The somewhat lower specificity may be the result of using a less sensitive standard (culture) as part of the comparison.
IPV victimization in pregnancy increases postpartum STI incidence among adolescent mothers in Durban, South Africa
Published in AIDS Care, 2020
Luwam T. Gebrekristos, Allison K. Groves, Luz McNaughton Reyes, Suzanne Maman, Dhayendre Moodley
Outcome: Laboratory-diagnosed STI was assessed at 6 months postpartum. Participants completed cervico vaginal swabs to test for 3 pathogens: Neiserria gonorrhea (Gonorrhea), Chlamydia trachomatis (Chlamydia), and Trichomonas vaginalis (Trichomonas). The BD ProbeTec ET Amplified DNA Assay (Becton Dickinson, MD, USA) employing Strand Displacement Amplification (SDA) was used for the direct detection of Gonorrhea and Chlamydia. Trichomonas was detected by in-house PCR. Participants who tested positive for at least one pathogen were coded as having a laboratory-diagnosed STI at 6 months postpartum. Participants who tested negative on all 3 pathogens were coded as not having a laboratory-diagnosed STI. STI incidence is calculated as the number of at least one laboratory-diagnosed STI per 100 person-years.
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