Trichomonas

T. vaginalis T. hominis

Compiled by ,
PB Wadigamangawa,
School of MLT, peradeniya
 TRICHOMONADS
Anterior tuft of 1 to 5 flagella

Median rod axostyle around which organism spirals

through medium

Undulating membrane, trailing flagellum

Habitat varies with species: digestive tract; mouth, crop,

colon; reproductive tract; uterus, vagina, prepuce

Non cyst or spore formed, direct immediate transmission

Trichomonas vaginalis
 Trichomoniasis
it is usually sexually transmitted disease.
This means that the disease is passed from person-
to-person only by sexual contact. Trichomoniasis
occurs in both men and women and is caused by
an infection with the single-celled parasite
Trichomonas vaginalis.
in rare instances it has been passed through wet
towels, washcloths or bathing suits.
Trichomoniasis is primarily an infection of the
urogenital tract; the urethra is the most common
site of infection in men, and the vagina is the most
common site of infection in women.
 Trichomoniasis
Trichomoniasis, like many other STDs, often occurs
without any symptoms.
When symptoms occur, they usually appear within 4
to 20 days of exposure,
painful urination,
painful sexual intercourse,
and a yellow-green to gray, sometimes frothy,
vaginal discharge.
The discharge is characteristically malodorous
smelling
In some cases, there may be vaginal soreness, and
abnormal bleeding after sex.
The symptoms in men include a thin, whitish
discharge from the penis and painful or difficult
urination. However, most men do not experience
any symptoms.
 Trichomoniasis
The labia may be irritated, red and itchy
Speculum examination may disclose a diffusely
red, inflamed vaginal mucosa, with vaginal
discharge either copious, thin, and foul-smelling
the parasites are found in the vaginal discharge
either by microscopic examination
or in laboratory cultures
. Sometimes the infections may be picked up on Pap
Smear
. a sample of fluid from the penis may be taken from
which the parasite can be grown in culture in the
laboratory
 Trichomoniasis
treated with either a large, single dose of
metronidazole 2000mg once
or with a smaller dose taken twice daily for one
week. 500mg bid x 7d
.In the first trimester of pregnancy,
substitute intravaginal clotrimazole 100mg
vaginal suppository qhs x7d, which is less
effective, but safer than metronidazole vaginal
gel.
Metronidazole is contraindicated in the first
trimester and controversial thereafter.
Treatment of asymptomatic patients can be be
delayed until after delivery.
. Male sexual partners of women with
trichomoniasis also must be treated.
Trophozoite, fresh examination
Trichomonas vaginalis: trophozoites live in vaginal cavity and urethra,
where they multiply when the vaginal condition is favourable (at pH 4).
Reproduction is by longitudinal fission.
Trophozoites are oval in shape, 10-23 m in length,
with four anterior flagella of equal lenght and a fifth flagellum
on the margin of the short undulating membrane.

The infection is usually acquired

by venereal contacts.
The male is the most important transmitter of the infection.
There is no cyst in the life cycle, so transmission is via the trophozoite
stage. These motile cells have four flagella and single nucleus. There is
also a median rod called the axostyle which is characteristic of the
trichomonads however, this is not clearly visible without staining the cells.

Pathogenesis of Trichomonas infections occurs by

cytopathogenicity against vaginal epithelial cells. Adhesion of
the parasite to the target cell is essential for the maintenance
of infection and for cytopathogenicity.
Laboratory Diagnosis:

1. Microscopic examination of wet mounts may establish the

diagnosis by detecting actively motile organisms. This is the most
practical and rapid method of diagnosis (allowing immediate
treatment), but it is relatively insensitive.

2. Direct immunofluorescent antibody staining is more sensitive than

wet mounts, but technically more complex.

3. Culture of the parasite is the most sensitive method, but

results are not available for 3 to 7 days. In women, examination
should be performed on vaginal and urethral secretions. In men,
anterior urethral or prostatic secretions should be examined.
Life Cycle
 Kinetosomes

Posterior flagellum

Parabasal body

Parabasal fibril
Trichomonas vaginalis Trophozoite, Giemsa stained
Tear drop shaped, 15-18 in length and 14-15 micrometer in width
Note an unduating membrane running about one-half of the body
Single nucleus
Axostyle is a characteristic of trichomonads
Flagellae at anterior end
T. hominis
Trichomonas hominis Trophozoite, Giemsa stained

Tear drop shaped, 7-15 in length and 4-7 micrometer in width

Note an undulating membrane running almost entire length of the body
and becomes finally free flagellum
Single nucleus
Axostyle is a characteristic of trichomonads
 nucleus

undulating membrane

costa
axoneme

Trichomonas hominis Trophozoite,

Giemsa stained

Tear drop shaped, 7-15 in length and 4-7 micrometer in width

Note an undulating membrane running almost entire length of the body
becomes finally free flagellum and the axoneme
Single nucleus
Axostyle is a characteristic of trichomonads
Trichomonas tenax
Trophozoite, Giemsa stained
Tear drop shaped
Note an unduating membrane running about three-third of the body
Single nucleus
Axostyle is a characteristic of trichomonads
 Trichomonas tenax
Mouth of humans

4 anterior flagella

Large numbers associated with poor dental

hygiene but not a cause of disease
May survive in drinking water a few days but
direct transmission more common

15% humans infected

Thank you