Correlation of Leukorrhea and Trichomonas vaginalis Infection

Abstract

Trichomonas vaginalis is a common sexually transmitted infection (STI) causing vaginitis. Microscopy has poor sensitivity but is used for diagnosis of trichomoniasis in resource-poor settings. We aimed to provide a more reliable diagnosis of trichomoniasis by investigating an association with leukorrhea. Women presenting for evaluation of vaginal discharge, STI exposure, or preventative gynecologic examination were evaluated for Trichomonas infection. Vaginal pH was determined and microscopy was performed by the provider, who recorded the number of polymorphonuclear leukocytes (PMNLs) per epithelial cell and the presence of clue cells, yeast, and/or motile trichomonads. Leukorrhea was defined as greater than one PMNL per epithelial cell. Culture and a nucleic acid amplification test (NAAT) were used to detect T. vaginalis. Patients were evaluated for Chlamydia trachomatis and Neisseria gonorrhoeae using NAATs and bacterial vaginosis using Gram stains. Two hundred ninety-four women were enrolled, and 16% were found to have Trichomonas (46/294). Trichomonas infection was more common in parous non-Hispanic, black women, who reported low rates of contraceptive use (33% versus 17%; P ‫؍‬ 0.02) and a STI history (85% versus 55%; P ‫؍‬ 0.002). These women were more likely to report vaginal discharge (76% versus 59%; P ‫؍‬ 0.02) and have an elevated vaginal pH (87% versus 48%; P < 0.001) and gonorrhea infection (15% versus 4%; P ‫؍‬ 0.002). Leukorrhea was associated with a 4-fold-increased risk of Trichomonas infection. Leukorrhea on microscopy was associated with Trichomonas vaginitis. Patients with leukorrhea should be evaluated with more-sensitive tests for T. vaginalis, preferably NAATs, if microscopy is negative.

A pilot study on Trichomonas vaginalis in women with recurrent urinary tract infections

“…In a population-based study, the prevalence of TV infection was not different between women with or without vaginal symptoms, including vaginal discharge, itching or odor [16] . In contrast, another study on women undergoing gynecological examinations revealed that those infected with TV were more likely to report vaginal discharge and leucorrhea [25] . However, only the women with leucorrhea diagnosed by microscopy were shown to have a 4-fold increased risk of TV infection in multivariate analysis.…”

High prevalence of Chlamydia trachomatis, Neisseria gonorrhoeae and particularly Trichomonas vaginalis diagnosed using US FDA‐approved Aptima molecular tests and evaluation of conventional routine diagnostic tests in Ternopil, Ukraine

“…However, the prevalence of TV was surprisingly high compared to neighbouring Poland (31), and Sweden (32) and Iceland (33) where TV has been extremely rare using the same Aptima TV assay. Instead, the high TV prevalence in Ukraine correlated more with TV prevalences described in Spain, the United States and other countries outside Europe (34)(35)(36). The reasons for this are likely multifaceted but include less frequent use of metronidazole in Ukraine (for suspected or confirmed bacterial vaginosis and/or trichomoniasis) compared to in Sweden (32) and Iceland (33), less universal access to high-quality health care, and other socioeconomic factors.…”

The anti‐Trichomonas vaginalis phloroglucinol derivative isoaustrobrasilol B modulates extracellular nucleotide hydrolysis

“…Neutrophils are considered primarily responsible for the cytological change observed at the infection site as well as the main cell in the inflammatory response against the parasite . Song et al .…”