- Trichomonas vaginalis (TV): 5-15 µm, pear-shaped, motile, flagellated protozoan parasite.
- Exists in the trophozoite stage only [Fig. 1; life cycle].
- Facultative anaerobe, divides by binary fission.
- Optimal growth in moist milieu at a pH of 4.9-7.5 and a temperature of 35oC-37oC.
- Trichomonads gather in clusters on the stratified urogenital epithelium, covering only a small surface area.
- Parasites invade superficial epithelium causing damage directly beneath the clustered trichomonads.
- Non-specific inflammatory response noted in the lamina propria with plasma cells, lymphocytes, and neutrophils present.
- Superficial ulceration of the epithelium can occur.
- A depressed level of secretory leukocyte protease inhibitor (SLPI) in cervicovaginal fluid, seen more often in females receiving hormonal contraceptives and those with vaginal pH >4.5, correlates with both T. vaginalis infection and poor reproductive outcomes in women
- Transmission issues:
- Can survive up to 45 minutes on clothing, washcloths, and in bath water.
- Presence of infection enhances acquisition of HIV infection.
- Antecedent bacterial vaginosis (BV), as defined by Nugent criteria, is a risk factor of T. vaginalis acquisition.
- T. vaginalis is strongly associated with an INTERMEDIATE Nugent score (0-3 = Normal, 4-6 = Intermediate, >6 = BV)
- T. vaginalis is strongly associated with an uncultivated member of the genus Mycoplasma which appears less pro-inflammatory than M. hominis.
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