Vaginal Trichomoniasis

Vaginal trichomoniasis is the most common STD caused by the flagellate protozoan Trichomonas vaginalis, mainly infecting the female vagina and also the male urethra by sex. Adult female infection rate can reach 95%.

Common Symptoms

Urethral itching; bacterial infection; increased vaginal discharge; frequency; inflammation; purulent discharge; lumbosacral pain; dysuria; pruritus; urgency

Causes and Pathogenesis

(1) Etiology: Donné (1836) first found T. vaginalis in vaginal discharge; named T. vaginalis next year. Like T. hominis/T. tenax, it has only trophozoite (no cyst). Fresh specimens are pear/oval, 9.7 (4.5-19) × 7 (2.5-12.5) µm; four anterior flagella and an undulating membrane drive motility; axostyle protrudes posteriorly. Ultrastructure: five kinetosomes in a ring, parabasal body, Golgi. Multiplies by binary/multiple fission (up to 16 daughter cells). Nutrition by osmosis plus pseudopodial phagocytosis; uses glucose/maltose/serum/peptone/digested casein; requires RNA, vit C, B-complex, pantothenate, phosphate. Grows at 25-42°C (optimum 32-35°C); survives 120-150 h at room temp, killed 50°C/4 min, -70°C/1 min; optimum pH 5.2-6.6 (inhibited <5.0 or >7.5). Facultative anaerobe; inhabits vagina but also urethra/uterus/paraurethral glands/bladder; in males mainly prostate/epididymis/prepuce. (2) Pathogenesis: virulence depends on strain, host physiology, vaginal flora. Acute/subacute strains are more virulent (abscesses in mouse skin, greater hemolysis). Ovarian hypofunction thins vaginal mucosa, reduces glycogen/lactobacilli, raises pH—favoring infection. Postmenstrual/pregnant women have higher rates. Fatigue/cold/enteric disturbance lower resistance. Trichomonads phagocytose sperm and cause discharge—some authors link to infertility. Exam: vulva/vagina/cervix congested with petechiae; red granular "strawberry patches" on posterior fornix; microscopy shows coagulated material with trichomonads/WBCs/RBCs; epithelium mostly intact but eroded at intercellular migratory sites; subepithelial lymphocyte/plasma cell infiltrate and necrosis.

Treatment

Drug therapy, TCM, supportive therapy

Preventive Measures

1. Health education; mass screening/treatment. 2. Sanitation; close pools to patients; improve public facilities; disinfection/isolation to prevent cross-infection. 3. Seek care at regular hospitals. 4. Treat patients/carriers; screen factory/school women. 5. For stubborn recurrent cases, check male urine/prostatic fluid and treat both. 6. Female condoms help.

Department to Visit

It is recommended to visit the Gynecology department; an appointment can be booked on this platform before the visit.

Warm reminder: The above information is for health science reference only and cannot replace professional medical diagnosis. If you have related symptoms, please seek medical attention at a regular hospital promptly.