Trichomonas infection

Trichomonads infection: description

The trichomoniasis or trichomoniasis infection is an infection with Trichomonas vaginalis, This is a parasite that belongs to the protozoa. Protozoa are unicellular organisms. Other protozoans are the malaria parasites and the causative agents of toxoplasmosis. Trichomonas vaginalis has a pear-like shape and carries thread-like structures on the surface, which are used for locomotion.

In women, the protozoan is most commonly detected in the vagina, urethra and paraurethral glands. Trichomonas can cause a vaginal and also a urethral and cervical infection. In man, Trichomonas vaginalis feels especially well in the urethra. Except for humans, Trichomonas vaginalis has no other reservoir where it survives for a long time. Outside the human body, the parasite usually dies quickly – except for wet objects and water. However, contaminated water does not have much importance from an epidemiological point of view.

The Durchseuchung with Trichomonas vaginalis can be estimated in part only because the disease is not notifiable. It is estimated that between five and ten percent of women in the industrialized countries and around one percent of men are affected. Around 52 new infections per 1000 inhabitants occur each year in Western Europe. Due to the frequent absence of symptoms of the infected Trichomonas vaginalis can spread quickly.

In addition to bacterial vaginosis and the fungal infection (candidiasis) of the female genital tract, trichomoniasis infection is one of the most common causes of vaginal complaints (vagina). A trichomoniasis infection should be detected early and treated. Otherwise, it can lead to complications in pregnancy. In addition, other sexually transmitted diseases are relieved, often resulting in multiple infections simultaneously.

Trichomoniasis Infection: Symptoms

In up to 85 percent of cases, the infection does not cause clear trichomonads symptoms. In all other cases, symptoms appear 2 to 24 days after the trichomoniasis infection. The most common symptoms of trichomoniasis are vaginal discharge, agonizing itching, pain when urinating or even unpleasant odor. The vaginal discharge is present in more than three out of four cases as a trichomonas symptom. The discharge is often foul-smelling, green and foamy. In addition, sexual intercourse is often painful. Non-specific abdominal complaints may also be associated with a trichomoniasis infection.

Trichomonads in men rarely trigger symptoms. The signs are nonspecific and manifest as urinary symptoms and urethral pain. Even low discharge from the urethra may occur. In rare cases, the glans is inflamed. The intensity and severity is, however, usually much lower than in the woman. In case of repeated and resistant complaints, however, the man should always be considered to have a trichomoniasis infection.

Trichomoniasis Infection: Causes and Risk Factors

The trichomoniasis infection is one of the so-called sexually transmitted diseases. This means that the infection with trichomonads happens in almost all cases during sexual intercourse. As a result, the infection is usually limited to the vagina and the lower urinary tract. But trichomonads can also be transmitted through contact with infectious bodily fluids, for example during petting or through shared towels. Since the majority of infected people show no symptoms, the transmission is often unconscious. The colonization of the urogenital tract with Trichomonas vaginalis and attachment to the body cells leads to an inflammatory reaction. These cells are mainly damaged by soluble substances excreted by Trichomonas vaginalis, and also destroyed.

In the context of the birthing process, a mother’s trichomoniasis infection can be transmitted to the child. However, this happens only in 2 to 17 percent of cases.

Infection of prepubertal girls is rare, as infection with Trichomonas occurs if any sexual contact that may have occurred is checked.

risk factors

Trichomoniasis infection is facilitated by estrogen deficiency in the vagina, damage to the vaginal flora and also foreign bodies such as forgotten tampons. Bacterial vaginosis also doubles the risk of trichomoniasis. In addition, certain diseases such as diabetes mellitus, immunosuppression, pregnancy, HIV infection or tumors increase the susceptibility to trichomoniasis. Statistically, trichomonads infections are more common with low socioeconomic status, changing sexual partners and poor hygiene. Patients with other sexually transmitted diseases often also have an existing trichomoniasis infection. Conversely, trichomoniasis makes it more sensitive to HIV infection.

Prevent

To protect against trichomoniasis, a condom should be used during intercourse. Good intimate hygiene is the basis of effective infection prevention. Even when bathing you should exercise caution. After swimming you should quickly put on dry clothes.

Trichomoniasis infection: examinations and diagnosis

The specialist in trichomoniasis infection is the woman’s gynecologist and the man’s urologist. The initial examination will ask questions such as:

• Are you familiar with infections of the urogenital area?
• Have you observed unfamiliar discharge from the vagina / penis?
• Do you have pain when urinating or having sexual intercourse?
• Have you had frequent changing sexual partners lately?

At the beginning, the genitals and, if possible, the urinary tract are examined. Swelling, redness and other signs of inflammation are first indications of an existing infection. A close examination of the female genitalia by a colposcopy with a special examination microscope shows further signs of inflammation and irritation. In up to 15 percent of infected women, the examination is unremarkable.

To determine if a trichomoniasis infection has actually occurred, one will smear examined from the vagina or vaginal secretions under the microscope. The protozoan Trichomonas can also be detected from urethral secretions or urine. Trichomonads can also be stained for microscopic viewing, but this requires experience. However, infection detection is best achieved by the experiment of cultivation the trichomonads from secretions or urine. There is also a molecular biological method (PCR), with the help of which the DNA can be detected.

Trichomoniasis diagnosis should simultaneously look for other existing sexually transmitted diseases, especially HIV. Likewise, it is important to ask for further sexual contacts in order to possibly treat partners.

Trichomoniasis Infection: Treatment

With proven Trichomonads infection one should always also treat the partner, In most cases, a single dose of two grams of the antibiotic is sufficient metronidazole, Another treatment option is the administration of two times four lower-dose tablets six hours apart on the first day and one tablet the next morning. Alternatively, especially with repeated trichomonas infections, 500 gram metronidazole can be prescribed twice daily for five to seven days.

Local administration of metronidazole in the form of a gel is not recommended as it often affects glands or other areas that are inaccessible to local therapy. Until the completion of trichomonas therapy, those affected should remain sexually abstinent.

When applying these therapy suggestions, there is one high probability of a successful recovery, In up to 20 percent spontaneous healing without trichomonas therapy is possible. During treatment, alcohol should not be consumed – this is true for up to 48 hours after taking the last tablet.

In the case of an existing pregnancy metronidazole can not be used carelessly. Especially in the first trimester of pregnancy, the application should be carefully weighed. There are a number of studies on metronidazole use, most of which give no indication of adverse effects of pregnancy therapy. In pregnant women, however, rather no high single-dose therapy should be performed.

If trichomoniasis symptoms persist or recur despite therapy, trichomoniasis diagnostics should be repeated and therapy may be intensified if necessary.

Trichomonads infection: disease course and prognosis

The Trichomoniasis can be treated well and therefore belongs to the group of curable sexually transmitted diseases. However, since trichomonads often cause no symptoms, the disease goes unnoticed for a long time – but can also heal in this time. An untreated trichomoniasal infection may affect the course of pregnancy. Important complications include premature birth and low birth weight. In rare cases, a trichomoniasis infection can lead to an ascending infection of the fallopian tubes. In men, this can cause a prostate inflammation. Added to this is the increased susceptibility to other sexually transmitted diseases. Among other things, for these reasons, rapid trichomoniasis therapy is needed especially for at-risk groups of sexual infections. After a through Trichomonas infection There is no protection against a new illness.