Trichomonas are single-celled (protozoan) animals that cause human diseases (trichomoniasis).
Kinds
There are three types of Trichomonas:
- intestinal,
- vaginal,
- genitourinary.
All three species are ubiquitous, although outbreaks of intestinal Trichomonas are more common in areas with tropical and subtropical climates.
Intestinal trichomoniasis (trichomoniasis)
This disease is caused by intestinal trichomonas and manifests itself with symptoms of colitis and enterocolitis.
When they enter the human body, parasites are localized in the large intestine, feeding on intestinal bacteria and sometimes red blood cells. They begin to multiply faster when consuming large amounts of carbohydrates and foods rich in fiber, as well as other diseases that cause diarrhea.
Routes of infection
Intestinal trichomonas are released into the external environment with feces. Their resistance to external influences is very high. In liquid feces they are stored at a temperature of 16-22ºС for 100 hours, at a temperature from -2ºС to +4ºС - 50-79 hours. In water they usually die after 15-30 minutes, but in lumps of mucus they can remain alive for 2 days.
Human infection occurs through water or products:
- marmalade,
- sunflower oil,
- tea (keeps for a few minutes),
- dairy products and fruit juices (stored for several hours).
Symptoms of intestinal trichomoniasis
These protozoa are opportunistic pathogens. They can parasitize a person for a long time without showing themselves in any way.
But when the immune system is weakened, they become pathogenic and begin to harm the body.
The following symptoms develop:
- loose and watery stools 1-8 times a day,
- abdominal pain of various types,
- stool with mucus, but no blood,
- temperature increase,
- chills,
- nausea,
- vomit.
A large number of Trichomonas are found in the stool.
Sigmoidoscopy reveals the following picture:
- the mucous membrane of the rectum and sigmoid colon is excessively moist, shiny,
- no redness is recorded,
- without mucus, erosions and ulcers,
- looks like it has been washed with a cleansing enema.
Diagnostics
To detect intestinal trichomonas, stool is examined and smears are taken. When examining smears, it is necessary to pay attention to the presence of vaginal and genitourinary Trichomonas, since they often parasitize together.
Treatment
The drugs metronidazole or tinidazole are recommended.
At the same time, antihistamines, immunomodulatory and restorative drugs are taken.
Prognosis and prevention
With proper treatment, complete recovery occurs.
To prevent the disease it is necessary
- drink clean water,
- pay attention to food products,
- Do not swallow water when swimming in bodies of water.
Vaginal and genitourinary Trichomonas
Trichomonas vaginalis attaches to the vaginal mucosa and can penetrate the submucosal layer.
Urogenital Trichomonas affects the urethra, vagina, and other parts of the reproductive system in women;
in men - the urethra, prostate gland and epididymis.
According to WHO, 10% of the world's population is affected by various types of the parasite.
In Russia, there is a steady increase in the incidence of genitourinary trichomoniasis. The source of infection is only humans. By attaching to the mucous membrane and penetrating the submucosal layer, protozoa cause inflammation, swelling, and infiltration.
The incubation period is 7-10 days, but can vary from 3-4 days to 1 month.
Symptoms in women
Classic symptoms of vaginal lesions are:
- inflammation of the mucous membrane,
- copious foamy discharge of gray-yellow color,
- blood in the discharge
- itching and burning in the external genital area,
- formation of erosions on the mucous membrane and on the inner surface of the thighs,
- pain during intercourse.
Particularly unpleasant symptoms appear before and after menstruation:
- swelling and redness of the skin of the vulva and the mucous membrane of the vestibule of the vagina,
- mucopurulent plaque in these areas.
The acute phase lasts weeks or months. Gradually, the inflammation decreases and the disease becomes chronic, while the inflammation of the mucous membrane disappears, and the discharge takes on a creamy appearance.
Infection can lead to complications:
- urethritis,
- cystitis,
- bartholinitis,
- cervicitis,
- endometritis.
Symptoms in men
In men, Trichomonas causes urethritis. Infection occurs through the distal urethra, after which the parasites spread throughout the mucous membrane.
The disease can be asymptomatic (in 60-70% of cases) or with periodic exacerbations (30-40% of cases).
Signs of the disease are the same as with most genitourinary infections:
- purulent discharge from the urethra,
- frequent urination,
- cutting pains.
Sometimes symptoms of systemic lesions may also appear:
- pain in the eyes (conjunctivitis),
- photophobia,
- swelling.
Infection with other sexually transmitted infections against the background of trichomoniasis is complicated by the ability of the latter to phagocytize (“swallow”) gonococci, chlamydia and other microorganisms that remain viable in them. When the body weakens, this leads to relapses of these diseases.
Trichomoniasis in men can lead to complications such as:
- prostatitis,
- vasculitis,
- epidymitis,
- reproductive dysfunction,
- cystitis.
The most common complication is prostatitis.
Symptoms in children
Trichomoniasis is rare in children, and only in girls. At a young age, they become infected from their mothers and through household items.
Routes of infection
Infection with vaginal and genitourinary Trichomonas occurs through sexual contact and through shared toilet items with infected people, in common toilet areas.
Trichomonas carriage
Quite often, the pronounced symptoms of trichomoniasis disappear and the disease becomes asymptomatic. But the person remains contagious.
Diagnostics
The material for detecting trichomonas is a fresh drop of vaginal discharge in women, vaginal rinsing, and urine.
In children, the best material for research is morning urine, collected in a sterile jar and delivered to the laboratory no later than 30-40 minutes after collection.
Before collecting urine, patients must follow a number of rules:
- three days abstinence from sexual intercourse,
- women should not douche during the day before collecting urine,
- men should refrain from urinating for 3-4 hours.
The resulting material is examined by microscopic and cultural methods.
Immunological methods are used as auxiliary methods.
Since the method of isolated microscopic examination of stained preparations often gives false-positive results, in children it is recommended to confirm the diagnosis of trichomoniasis by culture.
Treatment
Treatment for trichomoniasis should be carried out in all sexual partners, even if they have no symptoms.
Recommended drugs: nimorazole, secnidazole.
The previously widely used drugs metronidazole and tinidazole are now rarely used, since strains of Trichomonas resistant to them have become widespread.
In the treatment of urogenital trichomoniasis in children, ornidazole is recommended.
After the course of treatment, it is necessary to conduct control studies, but not earlier than 6 weeks.
Recovery is registered in the complete absence of symptoms and trichomonas in the study material for 1-2 months in men, 2-3 months in women.
Prevention
To avoid infection, it is necessary to avoid casual sex and use a condom.
If there is itching, discharge, pain, or inflammation, it is necessary to take tests up to 10 times.
Vaccination
To prevent the disease, the SolcoTrichovac vaccine (Switzerland) has been developed, which is created from inactive lactobacilli.
The vaccine is administered according to the following scheme: 0.5 ml 2 times every 2 weeks (vaccination should not coincide with menstruation) and once every year.
In the future, it is necessary to vaccinate once every two years. Vaccination can also be carried out against the background of treatment of genitourinary trichomoniasis.
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