Trichomonas vaginitis is a common gynecological diseases. It is caused by the Trichomonas vaginalis. Trichomonas can be directly passed through sexual intercourse, the woman, because, in her husband's urethra and prostate in patients with secretions, often can be found in the same type of trichomoniasis. Not only in the vaginal trichomoniasis parasite can also be parasitic on the lower urinary tract (urethra, and paraurethral glands) and the cervical canal, which is also in clinical trichomoniasis carriers do not have any symptoms. Parasite in the vagina vaginal trichomoniasis can consume glycogen, changes in vaginal pH, damage defense mechanism, easy to secondary infection. Accordingly, such carriers often in the period (or after pregnancy, postpartum and post-abortion) change of vaginal environment, suitable for growth and reproduction of trichomoniasis trichomoniasis vaginitis occurs very rare. The reason may be due to trichomoniasis is the food of glycogen, before puberty and women after menopause, due to poor ovarian function, estrogen level is low, the lack of glycogen in the vaginal mucosa, it is not suitable for growth and reproduction of trichomoniasis, which suffering from trichomoniasis vaginitis are less.
Three very similar in morphology trichomoniasis, Trichomonas vaginalis is the biggest one. The size of each strain, growth ability, and antigenic characteristics of virulence differences exist. Only trophozoites of Trichomonas vaginalis, no cysts period. Pear
-shaped or round trophozoites were long and 7-32 m, about 2-3 times the multi-core white, colorless, transparent, refraction. 5 arranged in front of a ring of hair matrix composite, has since issued four flagella and a former post-flagella, undulating membrane and the base also issued stain dry. Nucleus in the worm first 1 / 3, for the oval vesicular nuclei, nuclear matrix and near the deputy vice-based fiber, a longitudinal axis of column out worms from the back end. TEM: parasites surrounded by a double membrane, the body 1 / 3 have an oval nucleus, nuclear membrane bilayer, membrane, nuclear pore, nuclear electron density within the 6-10 high, similar to the size of the chromatin particles; membrane peripheral endoplasmic reticulum can be seen in the nuclear and sub-base fibers of the dorsal Golgi complex; body hair before the substrate complex, the flagellar tube cavity "C"-shaped shield structure and five three-part hair matrix composition.Trichomoniasis by the front four swing forward movement of flagellar membrane and to fluctuations in the spiral movement flutter action.Trichomonas vaginalis is a parasitic protozoa, anaerobic, strong adaptability to the external environment, can grow at 25-42 reproduction ,3-5 can survive 21 days in semi-dry state less able
to survive, but still capable of 6 hours of life. pH is 5.5-6.0, for the most appropriate growth and reproduction, 7.5 or pH <4.5, the growth inhibition.From the ultrastructural observations of non-intact mitochondria, this and other protozoa are very different, and the insatiable nature of addicted to optical light, the cathode bias power.In human body fluids, the state is different in the vaginal discharge can be seen breeding, breeding can also be found in semen, but no breeding in the urine. Parasite addicted to gas and anaerobic metabolism, glycolytic, ACA-ring on the base in the insect body contains enzymes, cell ATP enzyme respiratory enzyme cytochrome system, can take advantage of the nutrient solution with glycogen, glucose, fructose various amino acid protein. In the medium with glucose, also prompted strong breeding.
Trichomonas vaginitis worldwide, it is estimated that the number of infections for the United States each year 300 million women worldwide, 1.8 million, the foreign data show that: the number of trichomonas infection related to sexual with an adult infection rate to zero virgin. Trichomonas infection of 50 years is about 20% of married women, 70 years significantly decreased the incidence in recent years, some foreign countries or regions due to the ideological influence of sexual liberation, have increased the incidence of vaginal trichomoniasis, sexual strong function of the susceptible age.of infection is the parasite trichomoniasis patients and those, mainly direct transmission through sexual intercourse, but also through the public baths, swimming pools, toilet seat and other indirect communication.The virulence of Trichomonas vaginalis strains with the insect and host physiology, immune function, endocrine and vaginal bacterial or fungal infections within the change, especially women and the urogenital system in pregnancy when the physiological disorders are more vulnerable to inflammation. Few days after the infection, vaginal mucosa congestion, edema, epithelial cell degeneration and loss, leukocyte inflammatory response. Healthy women the role of the vagina due to lactic acid bacteria, pH values were maintained between 3.8-4.4, can inhibit the growth of other bacteria, trichomoniasis is not conducive to the growth of the vagina is called self-purification. However, the consumption of glycogen in the vaginal trichomoniasis impede glycolysis of lactic acid bacteria effects of lactic acid concentration, so that the vagina into the neutral or alkaline pH. Vagina after pregnancy and menstrual cycles so that the physiological pH close to neutral, which are conducive to breeding trichomoniasis, and thus higher rate of infection and recurrence.Early stage of infection, vaginal trichomoniasis on epithelial cell adhesion, and produce extracellular virulence factors. In addition to the adhesion process involves at least four adhesion proteins (2-65KD) participation, but also to the amoeba-like deformation of Trichomonas related to the reported virulence factors secreted by Trichomonas include: cell separation factor, the two cysteine protease (30KD and 6KD), and a hemolytic toxin. Hemolysis may be a direct effect of trichomoniasis with the result of red blood cells.Incubation period is usually 4-7 days. Women usually manifested persistent vaginal infection, acute onset can be slow. Trichomonas vaginitis mainly increased vaginal discharge, a foam, smell bad smell, yellow-green. Dysuria, genital itching. Acute phase for 1 weeks or months, often the severity of fluctuation, painful intercourse, menstrual period symptoms. Followed by vaginal reduced to alleviate the symptoms can also disappear, but patients who become parasite. Female patients at the first diagnosis of the disease, 50% asymptomatic. Trichomonas vaginalis in the urethra or bladder, if parasitic, urethral Trichomonas can cause bladder inflammation. Trichomonas vaginalis to swallow sperm can cause infertility. It was reported that T. vaginalis can cause abnormal cell growth and nuclear abnormalities, therefore, the incidence of cancer was significantly higher than women without trichomoniasis. Examination revealed mild from the vaginal vault and cervical hyperemia to extensive erosion, petechiae and perianal erosions, granular, friable, and flushing of the endometrium (strawberry cervix)
First, the hanging drop method:Hanging drop method is to check the easiest way of Trichomonas vaginalis, the positive rate of 80% -90%. Will be applied to the glass slide specimens, plus 1 drop of saline plus coverslip, with 100-200 times the examination, showing that fluctuations in parasite flagellar membrane activities. In saline with 5% neutral red, trichomoniasis is not death, not colored, and formed around the pink, white parasite of easy to recognize, or 1600 times the drops of acridine orange soluti into the fresh specimens by fluorescence microscopy, showing fluorescent green worm with a yellowish, especially good-looking, very high detection rate of direct microscopic examination.
The secretions applied to the glass slide can be dried naturally dyed with different dye, such as Gram stain, Reiter staining, Giemsa staining, PAS staining and staining leishmaniasis. This approach not only can see the shape and content of trichomoniasis, and can also see other micro-organisms exist in the vagina. Can also be used acridine orange staining, fluorescence microscopy.
Vaginal secretions or urethral discharge will be added within the medium, incubator at 37 for 48 hours, every 72 hours of vaccinati, take 1 drop of culture medium mixing smear staining.
Detection of specific antigens of Trichomonas vaginalis. Immunological methods are commonly used in fluorescent antibody test method, ELISA, latex agglutination, with its high positive rate than the smear, but clinical immunological methods generally do not use checks.1. Vaginal trichomoniasis: vaginal discharge frothy; cervix and vagina wall was characteristic strawberry-like appearance. Trichomonas examination positive.2. Male non-gonococcal urethritis trichomoniasis: urethra with mild swelling and a small amount of mucus, purulent or bloody discharge; may have cystitis or pyelonephritis; trichomoniasis check positive.1. Candida vaginitis: vulvovaginal itching, like cheese or bean dregs like vaginal discharge, vaginal white pseudomembrane. Positive for fungal examination.2. Bacterial vaginosis: non-white viscous purulent vaginal discharge; fishy vaginal discharge, positive amine test; vaginal pH value increased ,5.0-5 .5; secretions have a clue cells.
First, the local administrationEnhance the defense capabilities of the vagina, vaginal scrub with soap, cotton balls, after 0.5% lactic acid can be nitric acid or 1:5000 potassium permanganate solution or rinse the vagina. With bacterial infection, can the new clean Seoul 1:2000 solution rinse. Can choose any of the following: drop-dimensional net films, set a daily vaginal vault, 10, a course of treatment. Arsenic Kabbah ,0.2-0.4 g tablets into posterior fornix, 1 day, 7-10 as a course of treatment. Trichostatin daily into the vagina 10 million units, 10 for a course of treatment. Asha adriamycin, daily into the vagina a ,7-10 as a course of treatment. Before the local administration, to use the 0.5% acetic acid wash the vagina, to enhance efficacy.Second, traditional Chinese medicineTo heat, dampness, insect-based, common flavescens 30g, Cork 15g, Poria 30g, white moss Paper 30g, decoction of the vulva and vaginal washing after washing, then Cnidium, matrine and home vaginal suppositories made of the 9g in once a day, 10 times as one course of treatment.
Oral metronidazole (Flagyl), 500mg, 2 times a day for 7 days; or 2.0 single doses. Treatment of sexual partners is very important also, or may choose a single dose therapy. Metronidazole a significant effect, but now cases from the isolated invalid highly resistant to metronidazole of Trichomonas vaginalis strains. Because metronidazole has a disulfiram effect, it is the end of treatment during treatment and within 24 hours after prohibition of alcohol. Because metronidazole carcinogenic in rodents. Mutagenesis of the bacteria effe
ct. A precautionary measure, the first 3 months of pregnancy should not be used in pregnancy 3 months after the first oral metronidazole 2.0 treatment.Treatment Note: Check to negative after treatment trichomonas should be in the net after the reperiod and continue after the medication two courses in the period to consolidate the curative effect. Where it is negative for three consecutive months for the rewere cured. In addition, patients and their spouses should be emphasized that the common medication, be completely healed to prevent recurrence.Strengthening health mission, conducting general surveys and work carried out to eliminate the of infection, strict management system to prohibit patient access to a swimming pool, improve public health facilities, medical units do a good job of disinfection and isolation to prevent cross infection. For stubborn cases of recurrence, should be the man's urine or prostatic fluid of Trichomonas check for both treatment and control recurrence.
Friends Links:
Automation Control Blog
Automation Products Order Numbers
amniotic fluid embolism syndrome
ectopic pregnancy and methotrexate