Sites of Infection

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T. vaginalis infection is generally confined to the urogenital tract. There have, however, been rare reports of trichomonads being found in other sites such as the lungs and cerebrospinal fluid. These cases have usually been accompanied by a severe underlying disease. Rarely have the organisms been identified as T. vaginalis, but were most likely T. tenax or T. hominis.1

A case study published in 2003 tells of a 41 year old HIV+ male who was hospitalized due to fever and dyspnea. A cytologic examination of his bronchoalveolar lavage fluid revealed numerous T. vaginalis organisms. This is the first case where T. vaginalis was found in the lungs of an adult. Data collected suggest that trichomonads are overlooked parasites and may be implicated in various human pathologies.2

Women

T. vaginalis organisms may be isolated from the cervix, vagina, Bartholins glands, bladder, urethra and occasionally the upper reproductive/urinary tract.1 Over 95% of infections have been isolated from the vagina and only 5% from the urinary tract of adult women.3 The urethra and Skene's glands are infected in 90% of cases. There have also been instances where organisms were isolated from bladder urine.4

T. vaginalis may also act as a carrier for other pathogenic organisms. Keith conducted an in vitro study in 1986 to observe the attachment between T. vaginalis and other bacteria that inhabit the urogenital areas. Using scanning electron microscopy, one finding displayed a cluster of cocci attached to a trichomonad and two other demonstrated multiple cocci and E. coli attached to a T. vaginalis organism. Trichomonads have been shown to migrate to the fallopian tubes and peritoneal cavity. Thus, by carrying bacteria or viruses on their surfaces, it is possible that T. vaginalis organisms contribute to upper genital tract infections.5

In 2003, Rendón-Maldonado identified bacterial and protozoal STDs as important factors in the epidemiology of HIV-1. The research team incubated three subtypes of HIV-1 (A, B, and D) with HIV-1 infected lymphocytes and observed the interactions with immunofluorescence microscopy and transmission electron microscopy. Results showed that trichomonads may internalize HIV-1 particles for a short time period. Under in vitro conditions, trichomonads ingest and digest HIV-1 infected lymphocytes.6

T. vaginalis may actually transmit viruses. Pindak (1989) found virus-containing cell fragments engulfed by trichomonads and internalized in vacuoles. Viable reoviruses were recovered from the trichomonads for nine days and genital herpes simplex virus for six days, suggesting the possibility of transmission of viruses by T. vaginalis.7 More recent findings have further implicated T. vaginalis as host to multiple viruses, simultaneously.8

Men

In men the urethra is the most common site for T. vaginalis infection. Organisms can also be detected in the epididymis, semen, and urine.9

T. vaginalis was first located in prostatic fluid in 1936 by Drummond, who examined prostatic secretions from husbands of infected women.10 The organism has since been identified as a cause of prostatitis.11-12

  1. Rein MF, Muller M. Trichomonas vaginalis and trichomoniasis. In Holmes KK, editor. Sexually Transmitted Diseases. New York: McGraw Hill; 1990, pp. 481-492.
  2. Duboucher C, Noël C, Durand-Joly I, Gerbod D, Delgado-Viscogliosi P, Jouveshomme S, Leclerc C, Cartolano GL, Dei-Cas E, Capron M, Viscogliosi E. Pulmonary coinfection by Trichomonas vaginalis and Pneumocystis sp. as a novel manifestation of AIDS. Hum Pathol. 2003 May;34(5):508-11.
  3. Grys E. Topography of trichomonadosis in the reproductive organ of the woman. Wiad Parazytol. 1964:122-124.
  4. Thomason JL, Gelbart SM. Trichomonas vaginalis. Obstet Gynecol. 1989 Sep;74(3 Pt 2):536-41.
  5. Keith LG, Friberg J, Fullan N, Bailey R, Berger GS. The possible role of Trichomonas vaginalis as a "vector" for the spread of other pathogens. Int J Fertil. 1986 Sep-Oct;31(4):272-7.
  6. Rendón-Maldonado J, Espinosa-Cantellano M, Soler C, Torres JV, Martínez-Palomo A. Trichomonas vaginalis: in vitro attachment and internalization of HIV-1 and HIV-1-infected lymphocytes. J Eukaryot Microbiol. 2003 Jan-Feb;50(1):43-8.
  7. Pindak FF, Mora de Pindak M, Hyde BM, Gardner WA Jr. Acquisition and retention of viruses by Trichomonas vaginalis. Genitourin Med. 1989 Dec;65(6):366-71.
  8. Benchimol M, Chang TH, Alderete JF. Trichomonas vaginalis: observation of coexistence of multiple viruses in the same isolate. FEMS Microbiol Lett. 2002 Oct 8;215(2):197-201.
  9. Krieger JN. Urologic aspects of trichomoniasis. Invest Urol. 1981; 18(6):411-417.
  10. Drummond AC. Trichomonas Infestation of the prostate gland. Am J Surgery, 1936; 31(1):98-103.
  11. Guenthner PC, Secor WE, Dezzutti CS. Trichomonas vaginalis-induced epithelial monolayer disruption and human immunodeficiency virus type 1 (HIV-1) replication: implications for the sexual transmission of HIV-1. Infect Immun. 2005 Jul;73(7):4155-60.
  12. Gardner WA Jr, Culberson DE, Bennett BD. Trichomonas vaginalis in the prostate gland. Arch Pathol Lab Med. 1986 May;110(5):430-2.