trichomonas vaginalis is responsible for
a sexually transmitted infection known
as trichomoniasis and as we'll talk
about in a minute the symptoms mainly
occur in women in the vagina
now this STI is not caused by a
bacterium but rather a protozoan which
is a more advanced form of microorganism
than a bacterium and this protozoan
specifically is a parasite and it exists
mainly by eating cells that they destroy
so eating cell fragments and this
protozoa uses these cell fragments or
these pieces of cells for nourishment
now they typically have a pear shape to
them so I'll draw this pear shape here
so this is their body the cell body
these trichomonas or you can also refer
to them as trichomonas have one cell to
them so this is the one cell pear body
and they move around because of these
protein strands these whips that they
have that are called flagella flagella
and finally one of the other things you
might see if you take a look at this guy
under a microscope as we will in a
minute is the nucleus so here's the
nucleus now because trichomoniasis is a
sexually transmitted infection we have
to consider the mode of transmission or
how does it commonly spread from one
person to the other and as the name sort
of suggests this occurs only through
vaginal sex and what makes this
infection very interesting is that the
trick ammonia protozoan can't survive
anywhere else so they can only live
within the urogenital tract now this
means they can live within women like in
the vaginal tract or in the urethra or
they can also live in men but the tricky
thing about that with men is that they
rarely have symptoms so they're
asymptomatic which means that they're
carriers of this infection so they're
asymptomatic carriers that can spread
this STI to women without even realizing
it so if we take a look at this woman
right here and I've drawn her urogenital
tract so we're taking a look at a
sagittal section or if we chop them in
half from head to toe down the middle
through the legs you can see here is the
bladder that leads out the urethra so
here's the urethra and here is the
vagina so the vagina at the top of the
vaginal tract is the cervix over here
and
this part that I won't label for our
conversation because we won't be talking
much about it this is the anus that
leads up to the rectum and the rest of
the GI tract so if a woman is infected
with trichomonas they're going to spread
into the vagina and spread up the
vaginal walls and we can take a look at
this on a larger scale here here are the
vaginal walls and we're leading up to
the cervix let's say that the
trichomonas is climbing up the vaginal
tract using its flagella right here I'll
draw these green and it latches on there
it'll use this type of mechanism to whip
itself upward and in doing so it causes
stress to the cell membrane that over
time as I'll show up here causes the
cell to die producing fragments that
used to be the cell that are scattered
into the vaginal tract and eaten up by
this parasite now your immune system
will recognize this and in response to
the trichomonas white blood cells will
be sent here to combat them and release
toxins and try and engulf them and eat
them to stop them from killing cells in
our body and as a result of this we will
get inflammation inflammation meaning
more cell death in response to the ones
that have been affected by the
trichomonas as well as a fever and other
systemic responses and that causes
irritation if we have white blood cells
fighting the trichomonas within the
urethra you can get urethritis which
will cause pain when you urinate and
that's referred to as dis meaning
painful urea meaning urination so
painful urination the same thing happens
up here with the vagina as well as with
the cervix because you can get vaginitis
as well as cervicitis cervicitis
irritation of these two will then make
sex rather painful causing what's
referred to as dis again meaning pain
Perry u Nia despair a union or painful
sex and as this battle continues you'll
have more dead cells dead white blood
cells dead protozoa falling through the
vaginal tract out producing frothy green
discharge and this also has a
characteristically bad smell or it's mal
odorous over time this inflammation can
actually cause some pretty bad effects
as well in women especially those that
are pregnant chronic irritation or
long-term
irritation can cause them to a deliver a
baby earlier than they should so that
leads to preterm labor also long-term
inflammation can cause irregularities in
cell formation or cell division at the
cervix over time producing cervical
cancer the idea though is that because
women tend to have symptoms we will
catch the trichomonas earlier on and
treat them as we'll talk about in men
there's a greater concern though because
they're asymptomatic so one of the
things that you can get with chronic
inflammation is prostate cancer which is
why as we'll see in a few minutes why
it's important to treat the symptomatic
patient as well as they're asymptomatic
sexual partner now let's move on and
talk about how do we diagnose
trichomoniasis well there are two main
tests that we can employ the first is
what's referred to as a wet mount which
is exactly kind of what it sounds like
you take a swab of the vaginal tract do
you take a swab let me draw that swab
right here and if we swab the vaginal
tract we'll get a sample of cells mucus
and hopefully some of the protozoa as
well from there you put the sample on
this slide so you put it on this slide
so there's our sample and you take a
look at it under a microscope and this
is what you'll see there'll be some
squamous cells so these simple squamous
vaginal epithelial cells as well as
these two guys which are actual
microscopic views of these trichomonas I
think you can see here there's the
nucleus the pear-shaped body and the
flagella that are present here the
second test you can do is a culture a
culture or just try and grow out the
trichomonas on a petri dish so here's
our petri dish over here and I've
smeared our sample from this swab right
there and we'll let it grow over about
five days then what you'll see here are
these trichomonads colonies that are
growing on this petri dish okay so now
that we've diagnosed trichomoniasis how
do we treat it well here - we're going
to use antibiotics and we can use the
culture up here to determine what
antibiotics the trichomonas will be
sensitive to so say let's put antibiotic
number one down there an antibiotic two
up here
over time you will see that antibiotic
too wasn't very used we still had these
trichomonas grow even though we had it
on our petri dish here whereas down here
antibiotic one created this space where
no trichomonas could grow so that way we
can have our culture determine what
antibiotics the trichomonas
are sensitive to so we can have our
culture determine sensitivity and
another important thing about treating
infected patients with trichomoniasis is
that their sexual partner should be
treated as well because remember if
their partner was a male they may not
have any symptoms
but are at risk for developing diseases
down the line now what if we wanted to
prevent trichomoniasis altogether how do
we achieve prevention well the trick
here like most STI s is to block
transmission and we do that by limiting
the amount of direct contact during
these modes of transmission so in this
case during vaginal sex use of a condom
so condoms can greatly reduce the rate
of spreading trichomonads potentially
from an asymptomatic carrier to a
susceptible patient and because
trichomonas vaginalis can only live
within the human urogenital tract if we
treated everyone that was carrying this
parasite we could eradicate the disease
from the planet