Reactive arthritis occurs after a preceding infection such as urogenital or gastroenteral tract infection. Trichomoniasis, due to Trichomonas vasinalis infection, is one of the most common causes of vaginitis. Reactive arthritis associated with trichomoniasis is uncommon and there has been no report in Korea. We present a 28 year-old woman who had oligoarthritis after Trichomonas vaginalis infection. The arthritis subsided with treatment of the Trichomoniasis with metronidazole and non-steroidal anti-inflammatory drug.
Adult ; Arthritis ; Arthritis, Reactive* ; Female ; Humans ; Korea ; Metronidazole ; Trichomonas Infections ; Trichomonas vaginalis* ; Trichomonas* ; Vaginitis

BACKGROUND: Infectious vaginitis is caused primarily by three different groups of microbial pathogens (Trichomonas vaginalis, Candida spp., and Gardnerella vaginalis). The objective of this study was to compare the Affirm VPIII assay using a DNA hybridization technique with the Papanicolaou (Pap) smear test and the Gram stain in the detection and identification of these three organisms. METHODS: A total of 300 vaginal samples were collected from women that were either symptomatic for vaginitis or asymptomatic women that were being seen for routine obstetric or gynecological care. The presence of T. vaginalis, Candida spp., and G. vaginalis was evaluated by using the Affirm VIII assay (Becton Dickinson, USA), Pap smear test, and Gram stain method, respectively. RESULTS: With the Affirm VPIII assay, 1 (0.3%) patient tested positive for T. vaginalis, 99 (33.0%) patients were positive for G. vaginalis, and 18 (6.0%) were positive for Candida spp. The detection rates of Trichomonas infection, bacterial vaginosis and candidiasis by the Pap smear test and Gram stain method were 0.7% versus 0%, 16.3% versus 35.7%, and 1.7% versus 9.7%, respectively. The differences between the detection rates of the above three organisms between the Pap smear test and the Gram stain method were statistically significant (p<0.05). CONCLUSION: The Affirm VPIII assay was more sensitive than the Pap smear test and more specific than the Gram stain method for the detection and identification of these three organisms. In addition, the results of the Affirm VPIII assay are quick to obtain and are simple and easy to interpret.
Candida ; Candidiasis ; Chimera ; DNA ; Female ; Gardnerella ; Gardnerella vaginalis ; Humans ; Trichomonas ; Trichomonas Infections ; Trichomonas vaginalis ; Vaginal Smears ; Vaginitis ; Vaginosis, Bacterial

We conducted a community-based study of the prevalence of sexually transmitted diseases in rural and periurban communities in Eastern Highlands Province. We interviewed a stratified random sample of women and men, examined the women for evidence of sexually transmitted diseases (STDs) and collected specimens for diagnosis of syphilis, by serology and dark-field microscopy, gonorrhoea, by Gram stain and culture, chlamydial infection, by polymerase chain reaction (PCR) and direct immunofluorescence (DIF), trichomoniasis, by wet mount, and bacterial vaginosis, by wet mount and Gram stain. The men were tested for chlamydial infection only (first void urine tested by PCR and DIF). 201 women and 169 men were tested. Additionally, adults in the same communities who had not been randomly selected were offered the same services. An extra 243 women and 85 men were tested in this way. The laboratory results confirmed the clinical impression of an extremely high prevalence of STDs in this population. Among those randomly selected, 46% of the women had trichomonal vaginal infections and 26% had Chlamydia trachomatis infections detected by PCR, while 25% of the men had chlamydial infections. Other infections were much less common. 58% had one or more STDs. The prevalence of infection in self-selected adults was similar to that found in those randomly selected.
Chlamydia Infections - diagnosis ; Chlamydia Infections - epidemiology ; Data Collection ; Papua New Guinea - epidemiology ; Prevalence ; Rural Population ; Sexually Transmitted Diseases - epidemiology ; Trichomonas Vaginitis - diagnosis

Trichomoniasis is a sexually transmitted disease by Trichomonas vaginalis infection that may be associated with preterm delivery and low birth weight in the newborn infants. T. vaginalis may be transmitted to neonates during passage through an infected birth canal and neonatal infection is usually self-limiting course, but rare cases of symptomatic neonatal infection such as vaginitis, urinary tract infection and respiratory infection have been reported. We experienced a case of symptomatic neonatal trichomoniasis which was confirmed by wet mount examination of vaginal discharge and urine specimens in premature baby with intrauterine growth retardation. The patient had complete resolution of symptoms such as vaginal discharge and pyuria after treatment with ornidazole (tiberalR). We report this case with a brief review of the related literatures.
Fetal Growth Retardation ; Humans ; Infant, Low Birth Weight ; Infant, Newborn ; Ornidazole ; Parturition ; Pyuria ; Sexually Transmitted Diseases ; Trichomonas vaginalis ; Urinary Tract Infections ; Vaginal Discharge ; Vaginitis

PURPOSE: We aimed to investigate the detection of nanobacteria (NB) from expressed prostatic secretions (EPS) in patients with category III chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) and from vaginal swabs in patients with vaginitis by reverse transcriptase polymerase chain reaction (RT-PCR) and to evaluate the association between NB and Neisseria gonorrhea, Chlamydia trachomatis, Ureaplasma urealyticum (U. urealyticum), Mycoplasma hominis, Trichomonas vaginalis, and Mycoplasma genitalium. MATERIALS AND METHODS: A group of 11 men attending a specialized CP/CPPS clinic and a group of 157 women who reported symptoms of lower genital tract infection were enrolled in this study. NB were detected by RT-PCR. A Seeplex Sexually Transmitted Disease Detection assay (Seegene Inc., Seoul, Korea) was used that could detect DNA for 6 types of sexually transmitted pathogens. RESULTS: In EPS samples, the detection rate of NB in patients with CP/CPPS was 9.1%, and 9 (5.7%) of 157 vaginitis patients showed positive results in RT-PCR for NB in vaginal swabs. Associations observed among the 7 microorganisms included 6 (54.5%) patients who tested positive on EPS and 75 (47.8%) patients who tested positive on vaginal swabs. Five patients with vaginitis were found to have monoinfection of NB (6.7%). CONCLUSIONS: We found that conventional RT-PCR for NB was rapid, simple, low in cost, and easily available for the detection of NB, and that NB may be a possible etiological factor for vaginitis and CP/CPPS. The prevalence of U. urealyticum among the four patients with NB coinfection was 75%; the presence of U. urealyticum might therefore raise suspicion for nanobacterial infection.
Calcifying Nanoparticles ; Chlamydia trachomatis ; Coinfection ; DNA ; Female ; Gonorrhea ; Humans ; Male ; Mycoplasma ; Mycoplasma hominis ; Nanoparticles ; Neisseria ; Pelvic Pain ; Prevalence ; Prostatitis ; Reproductive Tract Infections ; Reverse Transcriptase Polymerase Chain Reaction ; RNA-Directed DNA Polymerase ; Sexually Transmitted Diseases ; Trichomonas vaginalis ; Ureaplasma urealyticum ; Vaginitis

Bronchopulmonary infections caused by trichomonads have been reported principally in patients with pre-existing pulmonary diseases, such as bronchial carcinoma, lung abscess, or bronchiectasis. Pulmonary trichomoniasis is most often caused by Trichomonas tenax, which is usually regarded as a harmless commensal organism of the human mouth. However, pulmonary infection may rarely be caused by other trichomonas species, including Trichomonas vaginalis from the genitourinary tract and Trichomonas hominis from the intestines. Because of the rarity of trichomonas pulmonary infection, and because of its close association with underlying lung and systemic disease, pulmonary trichomoniasis is considered an opportunistic infection. We recently treated a case of pulmonary trichomoniasis occurring in a young, healthy male without obvious underlying pulmonary or systemic illness. To our knowledge, there has been only one reported case of pulmonary trichomoniasis in Korea, and there have been only two reported cases of pulmonary trichomoniasis occurring in normal lung worldwide.
Bronchiectasis ; Carcinoma, Bronchogenic ; Humans ; Intestines ; Korea ; Lung ; Lung Abscess ; Lung Diseases ; Male ; Mouth ; Opportunistic Infections ; Polymers ; Trichomonas ; Trichomonas vaginalis

Trichomonas vaginalis commonly causes vaginitis and perhaps cervicitis in women and urethritis in men and women. Macrophages are important immune cells in response to T. vaginalis infection. In this study, we investigated whether human macrophages could be involved in inflammation induced by T. vaginalis. Human monocyte-derived macrophages (HMDM) were co-cultured with T. vaginalis. Live, opsonized-live trichomonads, and T. vaginalis lysates increased proinflammatory cytokines, such as TNF-alpha, IL-1beta, and IL-6 by HMDM. The involvement of nuclear factor (NF)-kappaB signaling pathway in cytokine production induced by T. vaginalis was confirmed by phosphorylation and nuclear translocation of p65 NF-kappaB. In addition, stimulation with live T. vaginalis induced marked augmentation of nitric oxide (NO) production and expression of inducible NO synthase (iNOS) levels in HMDM. However, trichomonad-induced NF-kappaB activation and TNF-alpha production in macrophages were significantly inhibited by inhibition of iNOS levels with L-NMMA (NO synthase inhibitor). Moreover, pretreatment with NF-kappaB inhibitors (PDTC or Bay11-7082) caused human macrophages to produce less TNF-alpha. These results suggest that T. vaginalis stimulates human macrophages to produce proinflammatory cytokines, such as IL-1, IL-6, and TNF-alpha, and NO. In particular, we showed that T. vaginalis induced TNF-alpha production in macrophages through NO-dependent activation of NF-kappaB, which might be closely involved in inflammation caused by T. vaginalis.
Animals ; Cells, Cultured ; Cytokines/*immunology ; Humans ; Macrophages/*immunology/parasitology ; Nitric Oxide/*immunology ; Trichomonas Infections/*immunology/parasitology ; Trichomonas vaginalis/*immunology

Trichomonas vaginalis commonly causes vaginitis and perhaps cervicitis in women and urethritis in men and women. Macrophages are important immune cells in response to T. vaginalis infection. In this study, we investigated whether human macrophages could be involved in inflammation induced by T. vaginalis. Human monocyte-derived macrophages (HMDM) were co-cultured with T. vaginalis. Live, opsonized-live trichomonads, and T. vaginalis lysates increased proinflammatory cytokines, such as TNF-alpha, IL-1beta, and IL-6 by HMDM. The involvement of nuclear factor (NF)-kappaB signaling pathway in cytokine production induced by T. vaginalis was confirmed by phosphorylation and nuclear translocation of p65 NF-kappaB. In addition, stimulation with live T. vaginalis induced marked augmentation of nitric oxide (NO) production and expression of inducible NO synthase (iNOS) levels in HMDM. However, trichomonad-induced NF-kappaB activation and TNF-alpha production in macrophages were significantly inhibited by inhibition of iNOS levels with L-NMMA (NO synthase inhibitor). Moreover, pretreatment with NF-kappaB inhibitors (PDTC or Bay11-7082) caused human macrophages to produce less TNF-alpha. These results suggest that T. vaginalis stimulates human macrophages to produce proinflammatory cytokines, such as IL-1, IL-6, and TNF-alpha, and NO. In particular, we showed that T. vaginalis induced TNF-alpha production in macrophages through NO-dependent activation of NF-kappaB, which might be closely involved in inflammation caused by T. vaginalis.
Animals ; Cells, Cultured ; Cytokines/*immunology ; Humans ; Macrophages/*immunology/parasitology ; Nitric Oxide/*immunology ; Trichomonas Infections/*immunology/parasitology ; Trichomonas vaginalis/*immunology

It is known that physicochemical conditions (e.g., pH, temperature, and ionic strength) affect the size of trichomonads. In this study, the sizes of 4 isolates of Trichomonas vaginalis cultured for more than a year (called "old T") and 3 isolates freshly isolated from vaginitis cases (called "fresh T") were compared by scanning electron microscopy. Although the fresh T had shorter body length, body width, and flagellar length than old T, total length (about 26 microm), including body length, flagella length, and axostyle length was almost the same in the 2 groups. A striking difference was observed between the axostyles of the 2 groups; the axostyle length of the fresh T (8.2 microm) was more than twice as long as that of the old T (4.0 microm). However, in several parasitology textbooks, the length of T. vaginalis is said to vary widely from 7 to 32 microm, and its undulating membrane is said to extend about half way (53.5%) to the posterior end of the body. On the other hand, in our study, the undulating membrane was observed to extend more than 3/4 of the body length (72.1%) in old T, whereas in fresh T it could not be measured. Taken together, we suggest that T. vaginalis averages 26 (21-32) microm in total length, with 9.5 (7.4-11.4) microm of body length and 6.8 (5.3-7.7) microm of width, and its undulating membrane extending 3/4 of its body length. Therefore, these findings may provide useful information for morphological characteristics of T. vaginalis.
*Biometry ; Female ; Humans ; *Microscopy, Electron, Scanning ; Organelles/ultrastructure ; Trichomonas Infections/parasitology ; Trichomonas vaginalis/*cytology/isolation & purification/*ultrastructure

Trichomoniasis is an important sexually transmitted disease that is associated with increased perinatal morbidity and increased HIV transmission. Infection with Trichomonas vaginalis also results in local urogenital tract symptoms. Standard teaching is that trichomoniasis is an important cause of vaginitis in women, but that male sexual partners experience little or no morbidity. It is worth-while to summarize critical findings in a series of articles. The prevalence of Trichomonas vaginalis in men represents an important consideration in the differential diagnosis of urethritis.
Animals ; Humans ; Male ; Sexually Transmitted Diseases ; epidemiology ; parasitology ; physiopathology ; Trichomonas Infections ; epidemiology ; parasitology ; physiopathology ; Trichomonas vaginalis ; Urethritis ; parasitology