Hormone changes produced during pregnancy predispose a higher incidence of infections of the lower genital tract. This leads to maternal and perinatological complications. The diagnosis of Trichomonas vaginalis infection during pregnancy is of great importance as such infections are related to premature rupture of membranes, preterm delivery, and low birth weight [1,2].Trichomoniasis is a sexually-transmitted disease associated with urethritis, vaginitis, cervicitis, pelvic inflammatory disease, and tubal infertility [3][4][5], and it is also linked to cervical cancer [6]. Up to 10 to 50% of infected women are asymptomatic and 50% of these women will develop clinical symptoms during the subsequent 6 months [7]. Moreover, reinfection may occur by sexual contact with the man who acts as an asymptomatic carrier [8].The laboratory diagnosis by microscopic examination has low sensitivity (35-80%) mainly in asymptomatic patients due to the low number of organisms in the sample. This is why it is necessary to implement more sensitive methodologies [9]. In the case of direct microscopic examinations, the detection of T. vaginalis depends on the microscopist's expertise and on the swift transport and processing of the sample, in order to avoid the loss of motility of the parasite [4]. Consequently, the liquid culture medium for T. vaginalis is considered the most accurate method (gold-standard) for the diagnosis of trichomoniasis [6,[10][11][12][13].The objectives of this work were to survey the prevalence of infection in asymptomatic and symptomatic pregnant women and to assess the utility of different microscopic methodologies for the diagnosis of trichomoniasis in pregnant women and to compare them with the method using the liquid culture medium.A total of 597 vaginal exudates from pregnant women were Prevalence and Comparison of Diagnostic Methods for Trichomonas vaginalis Infection in Pregnant Women in ArgentinaKorean J Parasitol. Vol. 48, No. 1: 61-65, March 2010 DOI: 10.3347/kjp.2010 61 Abstract: The objectives of this study were to conduct a prevalence survey of trichomoniasis in pregnant women and to evaluate the utility of different methods for its diagnosis. A total of 597 vaginal exudates from pregnant women who were examined at the Hospital de Clinicas in Buenos Aires, Argentina from 1 August 2005 to 31 January 2007, were prospectively and consecutively evaluated. The investigation of Trichomonas vaginalis was made by different microscopic examinations, and culture on liquid medium. The sensitivity and specificity of the microscopic examinations were assessed considering culture on liquid medium as the "gold standard". The prevalence of T. vaginalis obtained by culture on liquid medium was 4.0% (24/597). The prevalence of T. vaginalis obtained by direct wet smear, prolonged May-Grunwald Giemsa staining, and sodium acetate-formalin (SAF)/methylene blue staining-fixing technique was 1.8%, 2.3% and 2.5%, respectively. The sensitivity of the direct wet smear was 45.8%, that of the prolonged May-Grunwald Giemsa s...

The aim of this study was to evaluate different methods for Trichomonas vaginalis diagnosis during pregnancy in order to prevent maternal and perinatal complications. A total of 386 vaginal exudates from pregnant women were analyzed. T. vaginalis was investigated by 3 types of microscopic examinations direct wet mount with physiologic saline solution, prolonged May-Grunwald Giemsa (MGG) staining, and wet mount with sodium-acetate-formalin (SAF)/methylene blue method. PCR for 18S rRNA gene as well as culture in liquid medium were performed. The sensitivity and specificity of the microscopic examinations were evaluated considering the culture media positivity or the PCR techniques as gold standard. The frequency of T. vaginalis infection was 6.2% by culture and/or PCR, 5.2% by PCR, 4.7% by culture, 3.1% by SAF/methylene blue method and 2.8% by direct wet smear and prolonged MGG staining. The sensitivities were 83.3%, 75.0%, 50.0%, and 45.8% for PCR, culture, SAF/methylene blue method, and direct wet smear-prolonged MGG staining, respectively. The specificity was 100% for all the assessed methods. Microscopic examinations showed low sensitivity, mainly in asymptomatic pregnant patients. It is necessary to improve the detection of T. vaginalis using combined methods providing higher sensitivity, such as culture and PCR, mainly in asymptomatic pregnant patients, in order to prevent maternal and perinatal complications.

No abstract

A 35-year-old man presented with progressive right face, arm, and leg weakness, and diffuse headache. He lived in rural northwest Argentina. He had a past medical history of sexually transmitted diseases. On examination, he was alert and fully oriented, and had a right hemiparesis with hyperreflexia and an extensor plantar reflex. Apart from low grade fever, the rest of the physical examination was unremarkable. The complete blood count revealed leukopenia (3,300 leukocytes/mL); renal function, liver tests, electrolytes, erythrocyte sedimentation rate, and glucose level were normal. He tested positive for HIV with a CD4 count of 18 cells/mm 3 and viral load of 133,400 copies/mm 3 . Brain CT showed a nonenhancing left temporoparietal lesion with surrounding edema and midline shift.

Infections of the lower genital tract associated to maternal and perinatal complications frequently occur during pregnancy. The aim of this study was to evaluate vaginal dysfunction through the analysis of basic vaginal states (BVS) using the methodology of balance of the vaginal content (BAVACO) and to compare it with the microbiological study of candidiasis, trichomoniasis and bacterial vaginosis (BV). Pregnant patients (1238) were examined from 2010 to 2012. In asymptomatic (A) (n: 1046) and symptomatic pregnant women (S) (n: 192) BVS I was 59.5% and 26% of the patients, respectively. BVS II was observed in 19.7% of A and in 17.2% of S. BVS III was only detected in A in 0.4%. BVS IV was observed in 14.4% of A and in 38% of S. BVS V was detected in 6% of A and in 18.8% of S. Yeasts were associated to BVS I and II in 55.5% and 23.2% of A, respectively; and in 32.4% and 31% of S, respectively. Trichomonas were associated to BVS I in 50% of A, to IV in 44.4% of S and to V in 33.3% of S. BAVACO susceptibility to detect yeasts was 80.4% and 85.5% in A and S, respectively; 40% and 75% in A and S, respectively, to detect trichomonas and 100% in A and S to detect BV. BAVACO specificity was 100% for all pathogens in A and S. The study of BVS proved useful as a guide to evaluate vaginal dysfunction, regardless of symptomatology. Therefore, this study is recommended as prenatal control.