Trichomoniasis – Symptoms, Causes, Diagnosis and Treatment
Trichomoniasis is a specific lesion of the urogenital organs caused by a vaginal trichomonas (Trichomonas vaginalis) – the simplest single-celled parasite belonging to the flagellate class is called genitourinary trichomoniasis. This term is legalized by the International Classification of Diseases of the 9th Revision (M., 1984) instead of the various names used in the past.
Some patients also use other names: trichomoniasis, trichomonads, trichomoniasis, trichomonas, trichamonases, trichomanases, trichamonads, trichomonads. We will use the term trichomoniasis.
Trichomoniasis is a systemic infectious-inflammatory disease of the genitourinary system, which is caused by a simple trichomonas. To date, it is recognized as the first in prevalence among typical sexually transmitted infections and diseases of the genitourinary system.
There is trichomoniasis several times more often than chlamydia, syphilis, and HIV infection. All this suggests that the treatment of trichomoniasis is an important and urgent task.
Many researchers argue that the incidence of trichomoniasis in men and women is approximately the same and is about 10% of the adult population, but in men the disease is often transient, asymptomatic, is more difficult to diagnose, and therefore is much less likely to be registered than in women. For example, in England in 1975 the ratio of patients with trichomoniasis and gonorrhea of women was 1: 1.14, men – 1: 23.7, respectively. Perhaps this is affected by a different approach to diagnosing trichomoniasis in different countries and other factors.
Three types of trichomonads are parasitic in humans:
- oral (Trichomonas tenax);
- intestinal (Trichomonas hominis).
- Urogenital Trichomonas are an independent species, morphologically and culturally different from oral and intestinal Trichomonads. The causative agent of urogenital trichomoniasis is the trichomonas vaginalis Trichomonas vaginalis.Trichomonas vaginalis is a mobile unicellular organism that has adapted to life in the organs of the genitourinary system of a person.
An important feature of trichomonads is the ability to phagocytosis “swallowing” of microorganisms, including gonococci. However, studies have not confirmed the survival in Trichomonas chlamydia, and the average survival time of mycoplasmas and ureaplasma was about 3 hours. Trichomonases quickly lose vitality outside the human body. A prerequisite for life is the presence of moisture, when dried, they quickly die. Trichomonads are not resistant to high temperature (more than 40 C), direct sunlight, the effects of antiseptic agents.
Features of the pathogen
Outside the human body is able to live no more than a few hours, provided moisture is maintained.
Quickly dies when dried, exposed to direct sunlight, heated.
It is able to escape from the supervision of the immune system, disguised as host cells.
Other bacteria can penetrate into the trichomonads, where they find protection from the immune system and drugs. And due to its mobility, it is able to bring infectious agents of other sexually transmitted infections into the upper parts of the genitourinary system.
In turn, sexually transmitted infections can create more favorable conditions for the development of trichomonads. The most favorable conditions for this parasite: anaerobic environment, pH 5.2 – 6.2.
It can damage the epithelial barrier, which reduces its protective function, thereby facilitating the infection of other STIs, including HIV (human immunodeficiency virus).
Causes of Trichomoniasis
Genitourinary Trichomoniasis is an infection that is usually transmitted sexually and is often combined with gonococci, chlamydia, ureaplasmas, Gardnerella vaginalis and Candida fungi.
The source of infection is only people with clinically expressed or asymptomatic trichomoniasis. As a rule, infection occurs during sexual intercourse. Rectal and orogenital contacts do not lead to infection, as vaginal trichomonads do not survive in the oral cavity and rectum.
Out-of-the-box infection is extremely rare, mainly in girls. It is possible because parasites retain their activity for a short time in lumps of mucus or pus. Indirect infection through contaminated patients with hygiene items, underwear and medical instruments occurs under the same conditions as non-sexual contamination with gonorrhea.
The waterway of infection is now completely rejected. As an extremely rare exception, it is possible to infect women when bathing together in a bath with slightly mineralized water (salt concentration close to an isotonic solution).