Chronic Trichomoniasis in a Woman with Mixed Vaginitis Infection in Bandar Abbas, Iran: A Case Report

Document Type : Case Report

Authors
M. Ghobahi 1
M. Arfaatabar 2
M. Heydari Hengami 1
S. Bagheri-Josheghani 3
Z. Fakhrieh-Kashan 4
1 Infectious and Tropical Diseases Research Center, Hormozgan University of Medical Sciences, Bandar Abbass, Iran.
2 Department of Medical Laboratory Sciences, Kashan Branch, Islamic Azad University, Kashan, Iran.
3 Kashan University of Medical Sciences, Kashan, Iran
4 Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
10.29252/iem.6.4.305
Abstract
Background: Trichomonas vaginalis is, one of due to vaginitis, the most common non-viral sexually transmitted and treatable infection in the world. Co- infection of T. vaginalis along with other agents of vaginitis should always be considered in patients with chronic vulvovaginal symptoms.

Case: An Iranian woman with 32 years of age and signs of vaginitis infection referred to a midwifery clinic in Bandar Abbas. While she used antifungal and antibacterial medications many times during the past two years to treat her vaginitis infection, but since her husband did not do so, all the clinical signs of her infection reappeared again after a short time. A miscarriage, genital warts in the lower end of the uterus (cervix), yellowish-green foamy secretion, and vigorous redness of the lower end of the uterus were among the problems reported in her medical record. To diagnose the disease, sampling was done from the posterior fornix of vagina and using direct smear and Diamond culture medium, the specimen was examined for the presence of T. vaginalis by a specialist in parasitology. Based on the direct smear test results, the specimen was positive for yeast and bacteria and negative for T. vaginalis, while culture test result was positive for the presence of T. vaginalis. Therefore, the woman referred to a physician qualified in gynecology for her infection therapy, but this time with her husband. The duration of their treatment was three months, after which the culture test result (after 72 h) was negative for T. vaginalis, and the clinical signs of the infection ameliorated.

Conclusion: It is recommended that, in addition to careful examination of patients’ clinical symptoms, direct smear and culture methods be employed in midwifery centers to correctly diagnose vaginitis. In addition, the treatment of sexually transmitted diseases (STD) in people involved in a sexual relationship should be done simultaneously.

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[1] Simões-Barbosa A, Feijó GC, Silva JXd, Leal IIR, Barbosa TWP. A six-year follow-up survey of sexually transmitted diseases in Brasilia, the capital of Brazil. Br J of Infec Dis. 2002; 6(3): 110-7.
[2] Karabulut A, Alan T, Ekiz MA, İritaş A, Kesen Z, Yahşi S. Evaluation of cervical screening results in a population at normal risk. Inter J of Gyneco & Obste. 2010; 110(1):40-2.
[3] Nijhawan AE, Chapin KC, Salloway R, Andrea S, Champion J, Roberts M, et al. Prevalence and predictors of trichomonas infection in newly incarcerated women. Sex trans dis. 2012; 39(12).
[4] F Kashan Z, Arbabi M, Delavari M, Hooshyar H, Taghizadeh M, Joneydy Z. Effect of Verbascum thapsus Ethanol Extract on Induction of Apoptosis in Trichomonas vaginalis in vitro. Infec Dis -Drug Target. 2015; 15(2):125-30.
[5] Ka Sena AC, Miller WC, Hobbs MM, Schwebke JR, Leone PA, Swygard H, et al. Trichomonas vaginalis infection in male sexual partners: implications for diagnosis, treatment, and prevention. Clinical infectious diseases. 2007:13-22.
[6] Ryu J-S, Min D-Y. Trichomonas vaginalis and trichomoniasis in the Republic of Korea. The Korean journal of parasitology. 2006; 44(2):101.
[7] Poole DN, McClelland RS. Global epidemiology of Trichomonas vaginalis. Sex Transm Infect. 2013; 89(6):418-22.
[8] Ali V, Nozaki T. Current therapeutics, their problems, and sulfur-containing-amino-acid metabolism as a novel target against infections by “amitochondriate” protozoan parasites. Clini micro rev. 2007; 20(1):164-87.
[9] Arbabi M, Delavari M, Fakhrieh-Kashan Z, Hooshyar H. Review of Trichomonas vaginalis in Iran, based on epidemiological situation. J of repro & infer. 2018; 19(2):82.
[10] Ghobahi M, Hamedi Y, Shamseddin J, Heydari-Hengami M, Sharifi-Sarasiabi K. Frequency of Trichomoniasis and Related Risk Factors in the Women Referred to Bandar Abbas Health Centers, Iran, 2017-2018. Hormo Med J. 2019; 23(1):e88906.
[11] Habibi A, Nateghi Rostami M, Douraghi M, Dolati M, Rashidi BH, Ahangari R. Frequency of genital infection with Trichomonas vaginalis in women referred to gynecology hospital of the city of Qom. J of Dermato and Cos. 2016; 6(4):190-9.
[12] Kissinger P. Trichomonas vaginalis: a review of epidemiologic, clinical and treatment issues. BMC infec dis. 2015; 15(1):307.
Infection Epidemiology and Microbiology
Volume 6, Issue 4
November 2020
Pages 305-309