Trichomonas

According to scientific data, Trichomonas is found in 10% of healthy women and more than 30% of people who go to dermatovenereological clinics.

To inflammatory pathologies of the genitourinary organs, the causative agents of which are protozoa, include trichomoniasis.

Structure of Trichomonas

Trichomonads are classified as the simplest. They have a relatively high degree of organization, which includes all the vital functions (basic metabolism, mobility, reproduction, etc.).

Trichomonads under the microscope often have an oval-pear-like shape, but some conditions can give them an elongated, octagonal and other forms.

Trichomonas trunk consists of fine-grained protoplasm with multiple vacuoles. The outer thin cover is the periplast, which is provided on the front side of the trunk with a barely perceptible slit. It's a cystosome that acts as a mouth. Nearby there is a nucleus, which contains 5 or 6 nucleoli. Near the nucleus there are several grain-shaped corpuscles - this is a blepharoplast, from which the axonem thread stretches, serving as a kind of skeleton of a parasite.

The trichomonas are moved with the help of flagella and a wave-like membrane, it feeds on the human body phagocytic and endosomatic way.

Reproduction of Trichomonas occurs mainly through longitudinal or multiple division. It is interesting that under uncomfortable conditions for life (temperature change, action of medications, etc.) Trichomonas get rid of their motor organs (flagella), become round and motionlessly freeze, as if falling asleep for a while. Destructive for Trichomonads is sunlight: it slows down the movement and slows down the vital activity of parasites. They also die from drying out or with direct exposure to solutions of antiseptics. So, 1% carbolic acid, 1% chloramine or mercury dichloride destroy the trichomonas for several seconds.

To medicines in Trichomonads, resistance can develop.

How long does Trichomonas live? According to scientific data, it dies at a temperature of +55 C for 30 seconds, at a temperature of +43 C - in a day. To low temperatures the parasite is stable: at a temperature of -10 C it lives up to 45 minutes, at a temperature of +1 to +4 C, it remains viable up to 114 hours.

The life cycle of Trichomonas in artificial nutrient media passes only at a temperature of 36.5-37 C. It can retain its ability to live in acidic, neutral and slightly alkaline conditions. The optimal environment for trichomonads is 5.2-6.2 pH.

Types of trichomonads

There are several varieties of Trichomonas. One of the most potentially dangerous is the intestinal Trichomonas, and the most common is the oral one.

Reproduction of intestinal Trichomonas occurs in the intestine. This can provoke the development of such unpleasant diseases as gallbladder inflammation, erosion, anemia, enterocolitis, polyposis. The main signs of the defeat of the intestinal parasite are the muscle weakness and pallor of the skin.

Oral trichomonas, which is clear from the name, lives in the mouth of a person. Sometimes it is found in the respiratory canals, nasopharynx, circulatory system. The presence of such a parasite in the body can lead to the development of paralysis, arthritis and arthrosis of the limbs, liver diseases, pathologies of the reproductive sphere. One of the main signs of damage to the oral trichomonas are pyoderma, progressive caries, pulmonary diseases.

Urogenital Trichomonas (Trichomonas vaginalis - vaginal trichomonas) resides in the reproductive system, which is brought into sexual contact. It feeds on cells of the epithelium and various kinds of bacteria. The way of infection through bedding and personal hygiene items is so rare that it is practically not considered. The defeat of urogenital trichomonas can manifest as urethritis, endocervicitis, epidermitis, can lead to infertility and impotence.

There are no trichomonads that are safe for the body. All types of disease require mandatory examination and treatment.

How is trichomonas transmitted?

Infection occurs usually through sexual intercourse, and mostly after accidental sexual contact. Possible transmission of infection and through contact with personal items of the patient.

The development of Trichomonas may be favored by:

• high virulence of the pathogen;
• chronic pathologies in the body (diabetes, tuberculosis);
• decrease in immune forces in the body under the influence of external factors (toxicoinfection, hypothermia, malnutrition);
• Urethritis and vaginitis of various origin.

Often, the defeat of Trichomonas can be combined with gonorrhea or chlamydia.

Symptoms of Trichomonas

Trichomoniasis, as well as gonorrhea, does not produce immunity.

The incubation period with Trichomonas is on average equal to 10 days, but in some cases it can be reduced to 2-3 days, or may be prolonged to 30-40 days.

Trichomonas in men, usually as a type of acute or chronic form of urethritis, often representing a sluggish process. Cases of the latent course of the disease are described, as well as carriage of trichomonads without any signs of pathology.

The initial inflammatory reaction develops in the anterior lobe of the urethra, subsequently spreading to the posterior lobe. The disease is not characterized by a specific pattern of symptoms. The expression of subjective sensations is extremely insignificant and does not differ in constancy. Sometimes itching and burning in the urethra can be observed, painfulness may occur with the act of urination. Inflammatory reaction in the external opening of the urethra is rare. There may be a discharge from the urethra (purulent, mucous, transparent or mucopurulent, sometimes foamy).

Often affects the prostate, epididymis, glandular system of the foreskin, bladder, kidney. Pathology is often complicated by prostatitis, balanoposthitis and epididymitis.

There is no evidence of metastasis of Trichomonas. One can only assume that sometimes in the development of the complication of Trichomonas, other bacterial infections are to blame.

Trichomonas in women is most often localized in the urethra, vaginal cavity and cervical canal. Relatively rare trichomonads are found in the uterine cavity and fallopian tubes.

In the acute stage of the process, patients can complain about the presence of secretions, itching and burning of external reproductive organs. During the examination, there is pronounced puffiness, reddening, the presence of purulent-serous discharge. In some areas of the mucosa, erosion is possible. With a mirror examination, the patient notes painful sensations. Accordingly, pain is also observed during sexual intercourse. One of the most characteristic signs of trichomonads can be considered the appearance of foamy discharge.

When the urethra is affected, there are cutting pains during urination. If you press on the urethra, a drop of the separated substance may appear from it.

Chronic trichomoniasis is usually not very symptomatic.

Trichomonas during pregnancy

Trichomonas initially can prevent the onset of pregnancy, so in the period of preparation for conception, you should visit a doctor. Before the beginning of pregnancy planning, it is important to pass an analysis on possible infection with Trichomonas, as this is a fairly common pathology. And in half of the cases the disease runs without significant symptoms, so a woman may not even guess about a possible infection.

It is necessary to pay attention to some symptoms: urination disorders, inflammatory diseases of the genital area. At the slightest suspicion, you should see a doctor, as Trichomonas can provoke spontaneous abortion, premature labor, interfere with normal physical growth of the baby (the baby can be born prematurely or underdeveloped - weighing less than 2 kg).

If the pregnant woman shows obvious clinical signs (burning of the genitals, itching, foamy discharge) - the Trichomonas analysis and the doctor's consultation should be urgent.

Do not hesitate to undergo a Trichomonas examination in advance. This will make your pregnancy safe and save your health.

Trichomonases in children

The most common infection of children with Trichomonas occurs during childbirth, from an infected mother. Boys, this disease, as a rule, is not striking. Girls are prone to infection due to their anatomical features: first of all, the causative agent causes an inflammatory process that affects the external genitalia of the newborn. Disease in girls shows the same signs as in adult women (excluding, of course, subjective sensations): these are signs of puffiness, redness of the vaginal mucosa, the formation of erosion, pain during urination.

The first month of life may not show symptoms of the disease. This is due to the fact that along with the causative agent of the girl from the mother, antibodies to trichomonads that are fighting infection for a while are transmitted. However, by the end of the first month of life, the symptomatology is growing.

The home way of transmission of Trichomonas is considered extremely rare, but it exists. The child can catch, using other people's hygiene means: a towel, linen, a washcloth. Children need to explain what personal hygiene is, and why it is needed. Developing good habits in the child, we take care of his healthy future in advance.

Diagnosis of Trichomonas

It is necessary to know the fact that not always microscopic studies are guaranteed to detect Trichomonas. There are cases when even with a clearly marked symptom of a trichomonas lesion, parasites can be detected only after repeated examination. In this regard, to achieve plausible results, several repeated analyzes should be carried out, if possible using different laboratory methods. Trichomonas can be detected both in the native preparation and in stained smears.

The procedure for studying live Trichomonas in the smear is quite simple: a drop of warmed physiological solution is applied to the slide, a fresh drop of excretion is added to it; The resulting drug is covered with a special glass and examined under a microscope.

Treating trichomonads under a microscope is carried out by dry systems with an increase from 100 to 400 times. Most often parasites become visible even with an increase of 100 times. However, Trichomonas can also be represented by too small specimens, which can only be recognized with a larger magnification. The drug is usually treated in a darkened space, because sufficient illumination can mask the presence of transparent representatives of Trichomonas in the smear.

Microscopic examination must be carried out immediately after taking the material in order to prevent the influence of a change in the temperature regime and the drying of the preparation. Curiously, under the microscope Trichomonas are recognized by their pendulum, pushing, rocking mobility.

The role of culture research is also growing - sowing on Trichomonas. This method is used when suspicion of the presence of hidden and asymptomatic variants of the course of urogenital trichomoniasis, as well as to confirm the effectiveness of treatment of patients.

In situations where, for some reason, a smear can not be taken, a centrifuged first morning urine stream can be used for analysis. From it a special flake is extracted by a special pipette, which is then applied to a slide for examination.

Provocation to Trichomonases is carried out pricking proginala. This is done in order to temporarily weaken the immune defense of the body so that the causative agent (if any) is again visible in the smear. Provocation can serve and the reception of alcoholic beverages or spicy and salty foods.

The analysis of a blood on Trichomonases does not spend. There is another informative blood test, which determines the presence of antibodies to Trichomonas. It is called an enzyme immunoassay. The positive aspects of this method include the fact that the localization of the process does not matter for obtaining the results. Blood is given on an empty stomach, from a vein. The only condition for preparing for the analysis is the exclusion of alcohol and sharp salty foods overnight.

The method of polymerase chain reaction is another accurate diagnostic method that is based on the investigation of Trichomonas DNA. For such a study, you can use blood, discharge from the urethra, vagina, etc. Thanks to this type of diagnostics, pathogens can be detected at the initial stage of their development, which speeds up recovery and prevents further progression of the disease.

When preparing for in vitro fertilization, the method of parasitological examination for atrophozoites of trichomonads (vegetative forms of the pathogen) is often used: the vaginal discharge (seeding) is examined.

[1], [2], [3], [4], [5], [6], [7], [8], [9], [10], [11], [12]

Treatment of Trichomonas

Treatment procedures for Trichomonas are administered to patients, both with the presence of an inflammatory process, and without it. Treatment of carriers of trichomonads is mandatory, because they can become a source of infection of other people. In addition, the presence of parasites in the body is a risk of repeated manifestations of the disease. Therapies are exposed to the source of the infection and those who have sexual contact with it.

Sulfanilamide preparations and antibiotics with Trichomonas do not have a therapeutic effect: they are prescribed only in cases of mixed infectious flora. In such situations, antibiotics relieve the inflammatory response and promote a speedy recovery.

Significant effect in the treatment of trichomonads is metronidazole (flagel, trichopolum), which is used for oral administration.

The Trichomonas trichomonas treatment regimen is represented in three most popular variants:

• in a daily dose of 0.5 g, divided into two doses, for 10 days;
• the first four days - 0.25 g three times a day, the next four days - 0, 25 g twice a day;
• the first day - 0.5 g twice, the second day - 0, 25 g three times, on the third and fourth days - to 0, 25 g twice a day.

Some patients avoid the use of metronidazole because of side effects of the drug: dyspeptic disorders, stomach discomfort, vomiting. In such cases, the drug is replaced with ornidazole, which is much more easily tolerated by patients.

According to statistics, recovery after the first course of therapy is observed in about 90% of cases. Some patients may subsequently have posttrichomonas inflammation, which should be treated additionally.

After relieving the signs of acute inflammation, women who have been diagnosed with vulvitis and vaginitis can be prescribed syringing with a decoction of chamomile, sage.

Treatment of chronic trichomonas, as well as a complicated course of the disease, can be reduced to the use, in addition to the above treatment, of the methods used in the corresponding gonorrhea clinic. Also prescribe funds that stimulate the body's defenses (complex vitamins, immunostimulants - timogen, kipferon, imunoriks, isoprinosin, glutoxim, apilak, myelopid, prodigiozan).

Patients with Trichomonas are given tinidazole in the amount of 2 g as a single dose. For internal use, Nitazol tablets are released from Trichomonas, which contain nitazol, milk sugar, starch, talc and stearic acid. The drug is taken three times a day for 5-10 days.

As a topical treatment, effective combination of drugs levomitsetina (0.2 g), boric acid (0.1 g) and hexamethylene tetramine (0.5 g). In this composition, the drug is administered once a day in the vagina or the urethra, the course of treatment is 10-15 days.

Suppositories from trichomonads are used to treat the urogenital form of the disease. Usually, Clion D is used, which consists of metronidazole and miconazole nitrate. The agent is prescribed to women in the amount of one suppository at night, before going to bed. The course of therapy with such a drug is 10 days.

Male patients may be treated with Clion D in the form of tablets taken orally. A special effect of such treatment is observed with a mixed course of infection (simultaneous course of trichomoniasis with candidiasis).

A patient with a trichomonas can be considered cured, if after a completed course of treatment for two months in the laboratory tests, Trichomonas were not detected. Those patients who after treatment of Trichomonads have traces of inflammation or tissue dystrophy, physiotherapy procedures can be prescribed: application of phonophoresis, instillation, diathermy, massage, stamping with silver preparations, tamponade.

In the treatment of Trichomonas in children, usually the same metronidazole is prescribed, but at a lower dosage than in adults. At the same time, take sedentary baths or syringing with the use of weak solutions of antiseptics.

At the time of treatment, you need to follow a diet that excludes salty, sharp and fatty foods, as well as alcohol.

Treatment of Trichomonas in Pregnancy

In pregnant women, therapy is carried out only from the beginning of the second trimester, using the drug metronidazole and clotrimazole. In this case, treatment is assigned to both partners without fail.

• In the first trimester, the use of terzhinan, acylact and bifidumbacterin, which maintain the normal microflora of the vaginal environment, is allowed. Tablets are used daily for 10 days for 1 piece;
• in the second trimester, connect metronidazole (inside 0.5 g twice a day for a week), terzinan suppository, clion D, clotrimazole at night for 10 days, then acylact or bifidumbacterin for 10 days. For correction of immunity, rectal suppository wiferon may be prescribed twice daily for 10 days;
• in the third trimester also use metronidazole inside 0.5 g twice a day for a week. In general, the treatment in I and II trimesters is practically the same.

Every two weeks it is recommended to take a smear for Trichomonas to track the positive dynamics of treatment.

Alternative remedies for Trichomonas

Treatment of Trichomonas at home can be carried out solely as an addition to traditional treatment. You should not treat Trichomonas independently, without consulting a doctor: therapy of the disease must be controlled by the results of the tests.

• Trichomonas in the intestine. Often used antiparasitic plants, such as tincture of wormwood, carnations, natural phytoncides - garlic, onions, horseradish. The acidic and red berries have a harmful effect on the Trichomonas in the intestines: cranberry, mountain ash, viburnum, etc.
• Trichomonas in the genitourinary tract. Vaginal parasite can die almost immediately from the action of horseradish juice, onions, lemon. However, these plants can provoke burn mucous, so their use on the genitals is dangerous. For douches and sedentary baths, you can use infusions of coniferous trees, currant leaves and birch, herbaceous plants, cranberry berries, mandarin peel.
• Trichomonas in the prostate. Men with Trichomonas are recommended to use rinses or baths of herbal decoctions: bark of buckthorn, oak, tansy, field horsetail. A man should take such a sedentary bath with a warm broth for 15 minutes. A good help and kaolin clay: you need to take a tablespoon of clay and dissolve it in a liter of boiled water. Such a solution can be used to wash the genitals, or the bath.

Simultaneously with the treatment, you should change the food: do not eat sweet, baking, spicy seasonings, salty, fatty.

During the treatment it is desirable to abstain from sexual contacts, walk more outdoors, take food rich in vitamins to stimulate the body's immune forces.

[13], [14], [15], [16], [17], [18]

Prophylaxis of Trichomonases

Prevention of infections is the most important moment in a healthy lifestyle. And, if you take into account the specific features of the spread of the pathogen - sexual transmission - preventive measures are natural and generally available:

• You should not have sexual contact with a partner whose health you are not sure of. If you still decide on this connection, be sure to use a condom;
• respect the rules of personal and intimate hygiene. Use an individual towel, toothbrush, washcloth, do not wear other people's underwear. Do not forget to take a shower once or twice a day, paying special attention to the purity of the genitals;
• Periodically be examined at the doctor, even when signs of the disease are absent.

It should be noted that one should not be ashamed of the treatment of sexual infection. It's a shame, being sick or a carrier, to infect with the infection of others.

Trichomonas is a very common infection that must be treated, and it must be done without fail.

Sex with Trichomonas

Sexual contact is one of the main ways of infection by parasitic microorganisms. Transfer of the pathogen is possible both from the sick person and from the carrier of the infection, which in most cases does not even suspect its carrier.

Trichomonases are usually treated with two partners at a time. Therefore, if a man and a woman who undergoes simultaneous treatment of a disease want to live sexually during this period - this is permissible (provided the condom is used). In such cases, when one partner begins treatment earlier than the other, the risk of re-infection increases. In this situation, one should abstain from sex.

By the way, in many women, sexual contact in the presence of urogenital trihomonadnogo inflammatory process is extremely painful and unpleasant. Therefore, some refuse sex during the treatment period and for this reason.