Lab Diagnosis of Trichomonas vaginalis infections

Last updated on June 2nd, 2021

Trichomonas vaginalis in sample

Trichomonas vaginalis is a protozoan parasite. It causes trichomoniasis; a sexually transmitted infection. The primary habitat of this organism is vagina and prostate.
In infected female it causes itching and burning accompanied by profuse, foul-smelling, yellow- green vaginal discharge (about 25% women are symptomatic). Infected male are generally asymptomatic, some (about 10%) may develop urethritis. It is not possible to diagnose trichomoniasis based on these symptoms alone.

Note: Trichomonas vaginalis is not exclusive parasite of women, it also infects men.

Life cycle of Trichomonas vaginalis
Life cycle of Trichomonas vaginalis (image source: CDC)

Sample

 Specimen can be collected by using urogenital swabs.

  1. Female: Urine sediment, vaginal secretions
  2. Male: Urethral discharge or prostate secretions or first few drops of voided urine

Sample for culture should be placed into a tube containing 0.5mL of sterile saline or commercially available plastic envelopes for direct examination and culture (InPouch TV, BIOMED) immediately.

Methods

  1. Microscopy and staining:
Trophozoite of Trichomonas vaginalis
Trophozoite of Trichomonas vaginalis

Direct microscopic examination of a wet preparation of sample (vaginal discharge) provides the simplest rapid diagnostic test for vaginalis.  It includes detection of pear-shaped trophozoites (only form; there is no cyst form) of T. vaginalis in wet mount with typical jerky motility. Direct fluorescent Antibody (DFA) stain can be used to visualize the parasite.

Morphological features of Trophozoites: 

1. Pear-shaped organism with a central nucleus and four anterior flagella.
2. It has an undulating membrane that extends about 2/3rd of its length.

(Watch the video of vaginal discharge observed under phase-contrast microscopy here)

Culture: Culture is a very sensitive (95%) procedure for the diagnosis of trichomoniasis. It is recommended when a direct smear is negative. Johnson’s and Trussel’s medium gives a good growth of T. vaginalis. It consists of proteose peptone, NaCl, sodium thioglycolate, and human serum. It grows best at 35°C-37°C anaerobic conditions and less well aerobically. The optimal pH for growth is 5.5 to 6.0.  T. vaginalis can be cultured in commercially available diamond’s medium or plastic envelopes.

Serology: Better serologic test for T. vaginalis is not available.

Molecular Methods: Polymerase chain reactions (PCR) and nucleic acid hybridization methods can be used to detect T.vaginalis directly in clinical specimens.

About Acharya Tankeshwar 473 Articles
Hello, thank you for visiting my blog. I am Tankeshwar Acharya. Blogging is my passion. I am working as an Asst. Professor and Microbiologist at Department of Microbiology and Immunology, Patan Academy of Health Sciences, Nepal. If you want me to write about any posts that you found confusing/difficult, please mention in the comments below.