Genitourinary Trichomoniasis: Symptoms, Causes, Diagnosis, Treatment and Prevention
Jul 02, 2018
Urogenital trichomoniasis, or trichomoniasis, causes a vaginal trichomonas( Trichomonas vaginalis).In most cases, the causative agent penetrates into a person through sexual contact, especially with occasional sexual intercourse.There are known cases of infection through personal belongings, which the previously infected person already used. Table of contents: About the causative agent of trichomonias Where Trichomonas Occurs in the Body Where Trichomonas Occurs in the Body Complaints and Trichomoniasis Clinic
Trichomonas causative agent
Trichomonas is a microorganism of the Protozoa type, capable of all major vital types of organization: movement, reproduction, metabolism, nutritionetc.The shape of the microbe resembles a pear in its appearance, but it constantly changes due to movement and encounter of obstacles.The usual size of the vaginal trichomonas is up to 20 μm, sometimes individuals fall to 35 μm.
Note: larger forms are characteristic of the chronic stage of the disease.
The pathogen is caused by the phagocytosis method.Reproduction is by longitudinal or multiple division.Trichomonas can be transformed into a stationary stage, resistant to unfavorable environmental conditions, since the active form is very sensitive to changes in temperature parameters of habitat.Also harmful to the microbe is sunlight.
The chemical composition of the medium( acidic, neutral, slightly alkaline) is well tolerated by the pathogen.
Vaginal trichomonas live in the human genitourinary system.When penetration does not always cause clinical manifestations of the disease, as it successfully resists immunity.In this case we are dealing with trichomonadonositelstvom.
Inflammation of the urethra - trichomonous urethritis, occurs with increased activity( virulence) and weakening of the body.The latter include hypothermia, poisoning, severe illness, eating disorders.
Note: in isolated version of trichomoniasis does not occur as often.Usually several infections are simultaneously combined( gonorrhea, chlamydia).
Where the trichomonas live in the body
From the urethra, the causative agent of the disease can penetrate into the epididymis, the prostate gland.Some researchers reported in the results of their observations about the discovery of trichomonads in the blood and organs of man.They noted that microorganisms can be interstitial parasites.However, this idea has not received universal confirmation and requires rechecking.
The clinical picture of trichomonias lesions is non-specific.Manifestations of urethritis are the same for different types of pathogen( gonococci, chlamydia, trichomonads).
Immunity to trichomoniasis does not develop.
Complaints and clinic of trichomoniasis
The incubation period( from infection to manifestations) lasts on average 10 days, sometimes up to a month.
Symptoms of trichomoniasis in men
The patient complains of symptoms of urethritis:
- painful urination;
- increased urge to urinate;
- appearance of secretions( mucous, watery, foamy, purulent) from the urethra;
Trichomoniasis can spread to:
- seminal vesicles;
- bulbourethral glands;
- para-urethral ducts;
- of the foreskin;
- renal pelvis;
- skin of the glans penis( balanoposthitis);
The most common complications of trichomoniasis are prostatic inflammation( prostatitis) and inflammation of the epididymis( epididymitis).
Symptoms of trichomoniasis in women
In women with trichomoniasis, characteristic complaints appear:
- secretion from the genitals( abundant, often serous-purulent, foamy - specific for trichomoniasis);
- itching, burning, stinging when urinating;
- swelling and congestion( redness);
- occurrence of erosion in folds of the vaginal mucosa;
- soreness on examination, with pressure on the urethra - the appearance of secretions;
- macerated skin;
Acute condyloma often occurs at the same time.
The pathological process develops in:
- glands of the vestibule;
- of the uterine cavity;
- Fallopian tubes.
In the glands of the vestibule due to an edema, the excretory ducts overlap, and a "false" abscess is formed.
If the disease affects the cervix( endocervicitis), then there is swelling of the cervix, accompanied by abundant secretions.Often erosions are formed.
Note: the chronic variant of the disease passes asymptomatically, or with a "blurred" picture.
Methods of disease identification, laboratory diagnostics
Diagnosis of trichomoniasis is based on a comprehensive examination of the patient, including:
- collection of patient complaints;
- inspection data;
- laboratory diagnostics.Trichomoniasis does not give any specific manifestations.
Symptoms are equally characteristic for most sexually transmitted diseases.Therefore, in the diagnosis, the data of laboratory studies are of primary importance.
Laboratory diagnostics of trichomoniasis
Microscopic examination does not always allow finding the causative agent of the disease.Not always with pronounced symptoms of trichomoniasis, parasites are found in the material of the discharge of the urethra.Therefore, the diagnosis of trichomoniasis should be carried out by all possible laboratory methods and repeatedly.Only then it will be possible to achieve positive results.
Parasitic microbe is searched for:
- in smears using specific stains;
- in native preparations.
Native drugs are being tested to determine live trichomonads.A drop of human secretions is placed on a microscope slide with two drops of saline.A cover glass is applied to the mixture and an analysis is performed under a microscope.
The study in the "live" drop is made at magnifications from 100 to 400 times.These permits permit a good discernment of the movement of microbes.One and the same material is recommended to study at different resolutions, since the size of the pathogen can be very different.Sometimes shading is used, in which parasites become more noticeable.
Detection of trichomonads should be carried out as soon as possible after collection, avoid exposure to high or low temperatures, drying, as microorganisms quickly die in these conditions.
Important: is a specific feature of Trichomonas - their movement.At the same time, swings, jerky jerks,
can be observed. If there are no pathogens in the analysis, but with severe clinical symptoms, an additional version of the microscope is performed: the first urine stream is subjected to centrifugation, and after the appearance of threads, flakes, crumbs, a pipette, theseElements.They often manage to detect and identify the pathogen.
Observe the temperature of the test:
- the tube containing the material is kept in a glass of warm water;
- use a warm slide.
The use of biomaterial staining methods facilitates the detection of pathogenic trichomonads.
The most common colors are:
- with methylene blue( the core of the parasite appears more clearly);
- for Gram( the core acquires purple, and flagella and protoplasm a pink hue);
- for Romanovsky - Giemsa( the core becomes violet-red, the flagella red, protoplasm bluish);
- for Leishman( causative agents are light blue, the nuclei are purple).
In cases of asymptomatic flow, a culture method can be used.
Treatment of trichomoniasis
Treatment is necessary both in the case of existing complaints and without them, but when a pathogen is detected, since an asymptomatic carrier can be a source of infection.
Prophylactic carrier therapy is also necessary to avoid recurrence of the disease in treated patients without clinical manifestations.
Antibiotics and sulfonamide preparations used to treat most urogenital infections are ineffective against trichomoniasis.
Metronidazole( Flagil, Trichopolum) is used in therapy.The schemes of taking the drug depending on the form of the disease are developed.
Note: in 90-98% of cases it is possible to achieve recovery after a course of treatment of trichomoniasis.
To ease inflammation, local effects are applied by rinsing the urethra with solutions of Silver Nitrate, Mercuric Oxicanide, Etacridin.Then Osarsol with Boric acid and Glucose is injected into the canal.
Hexamethylene tetramine, Levomycetin with Boric acid, is effective.These compounds are injected into the urethra and into the vagina.
For women are recommended baths with chamomile, sage.
Treatment of trichomoniasis is supplemented by the use of Tinidazoda, Nitazol.
One of the well-proven drugs, "Clion D", is shown in the form of vaginal tablets, prescribed 1 time per day for 10 days.It is especially effective when combined infections.
Negative laboratory tests are considered as a criterion of cure at repeated repetitions within 2 months.
Physiotherapy procedures can be applied until the discomfort disappears completely.
It is important to remember that trichomoniasis is transmitted sexually, so the best way to protect against infection is to keep the relationship clean.Random, promiscuous sex is never good for health does not end.
One should not forget about the rules of personal hygiene.When there are complaints in the genital area, you should immediately consult a doctor, as early detection and treatment of diseases contributes to a rapid cure and the absence of the possibility of complications.
Alexander Lotin, medical reviewer