Trichomonas vaginalis is a flagellate that can cause sexually transmitted disease named after the organism (Trichomoniasis) but has also been reported to be caused by casual exposure through sharing moist towels, washcloths or even from Jacuzzis and hot bath. This flagellate has only a trophozoite stage (no cyst stage). Most infections are asymptomatic but it can cause genital tract itching and the formation of a white discharge from the genitals in both males and females. Diagnosis of Trichomoniasis depends on finding the flagellate in the discharge from patients. In many cases, the counts are low enough that it can be missed in the lab. and false negative results are not uncommon unless the trophozoite is propagated in special enriched media to increase the counts. Detection by Polymerase Chain Reaction is far more superior to conventional cultivation and microscopy and can produce results in a fraction of the time needed to grow this flagellate in the laboratory.

In a general, low risk population, the incidence of trichomoniasis is probably less than 1%. In sexually transmitted disease clinics, however, trichomonas may represent from 10-50% of women presenting with vaginal symptoms.

Microscopic examination would reveal an organism with four flagellae and a prominent nucleus. The diameter of the organism is 26 µm and it is round or slightly oval in shape.

What are the symptoms of Trichomonas vaginalis infection ?

Like many other sexually transmitted diseases, there may be no symptoms with T. V. , especially in men, but if there are they may include:

A vaginal discharge, yellow/green in color, which may smell unpleasant and look frothy.

Soreness, itching and inflammation in and around the vagina.

Frequent need to urinate and/or pain on urinating.

Pain when having sex.

Penile discharge.

Pain when passing urine.

Can Trichomoniasis be easily treated?

Yes, T. V. is treated. All recent partners should also be checked and treated if necessary. Abstinence is highly recommended until the doctor or clinic has given the patient the all-clear. Metronidazole (Flagyl®), 2 grams by mouth (usually 4, 500 mg tabs) for the woman and her partner(s) and Metronidazole 500 mg twice a day by mouth for 7 days. Topical application of anti parasitic medications is not recommended. Any medications should be decided by your physician and should be based on laboratory findings.

What are the effects of trichomonas vaginalis if left untreated?

Complications with T. V. are rare but can cause prostatitis, chronic urethritis and constant itching and pain in males while it can be transmitted through the birth canal to a baby girl if the mother is a carrier or is actively infected and showing symptoms.

It is not uncommon to be infected with Neisseria gonorrheaoe in patients that have Trichomoniasis.

What samples are best for the test?

Urethral or vaginal discharge are ideal for the test and should be collected using a sterile cotton swab and shipped cooled to the lab. (ice packs) overnight. Urine samples are acceptable but have been shown to yield lower sensitivity. Urine is usually spun down and the sediment is used for DNA extraction and the PCR reaction.