TEAM CASE STUDY 3. EUKARYOTIC – PROTOZOA. WELCOME.

HISTORY A 24 year old woman is referred to a health clinic as a result of contact from tracing a case of gonorrhoea. She recently had unprotected sex with her male partner but showed no symptoms. A pelvic examination recovers a greenish discharge containing protozoa with characteristic “jerky” motility. The woman tested negative for gonorrhoea.

INFORMATION & QUESTIONS. Medical history. Is she on any medications? Is she pregnant? Does she have any abdominal pain? Has her partner been examined? Has she had any other STDs before?

MORE QUESTIONS CONT. What’s her profession? Are there any known allergies in her history? Has she had any invasive surgeries ( abortion)? Has she been traveling?

DIFFERENTIAL DIAGNOSIS. Giardiasis-caused by a diplomonad protozoa of the intestinal tract. Cryptosporidiosis-caused by a parasite & acquired through contaminated drinking water or food, or exposure to fecal/matter. Bacterial Vaginosis-decline in lactobacilli. 1. Gardnerelle Vaginalis 2. Mycoplasma Hominis.

DIFFERENTIAL D. CONT. Reaction to disruption of normal microbiota by broad-spectrum antibodies. Candida Albicans (Yeast) –caused by erythromycin. Trichomonas Vaginalis-parasite that infects (Trichomonas) the reproductive sysytem. It is a sexualy transmitted diseases called Trichomoniasis.

LIST OF THE MOST PROBABLES. 1.Trichimoniasis- an oval trophozite with 5 flagella. Does not have a cyst. 2.Giardiasis- Has a cyst. Symptoms include abdominal pain, flatus, nausea, vomiting, loss of appetite, ineffective nutrients absorption, low fever, foul smelly stool( rotten eggs) like hydrogen sulfide. 3.Crytosporidiasis- banana shaped – diagnosis is made from the oocysts in the feces.

LIST CONT. 4.Yeast infection- caused by various species of candida. Vaginal discharge is curd like and slight. 5.Allergy- caused by erythromycin which kills the lactobacteria. 6.Bacteria Vaginasis- caused by gram positive bacteria which produces a whitish discharge.

MOST LIKELY ETIOLOGICAL AGENT. Trichomonas vaginalis.

TESTS. In men diagnosis is made from urethra specimen. In women a pelvic exam is performed &vaginal samples collected. Then the parasite is viewed under a microscope (wet mount). A culture.

TESTS CONT. Wet mount of the vaginal discharge. Stain viewed under fluorescent microscope. Polymerase chain reaction testing (PCR).

DIAGRAM 1. A trophozoite vaginalis from culture. Flagella and single nucleus are visible.

DIAGRAM 2. Two trophozoites of Trichomonas Vaginalis.

DIAGRAM 3. Trophozoites in a vaginal smear. ( Papanicolaou stain, oil immersion).

SCIENTIFIC CLASSIFICATION. Kingdom-Protista. Phylum-Metamonada. Class-Parabasalia. Order-Trichomonadida. Genus-Trichomonas. Species-T. vaginalis.

WHAT’S WRONG WITH THE PATIENT & HOW COMMON IS THE INFECTION? The patient has an infection called Trichimoniasis vaginalis. One of the most common infections in the United States, especially in HIV patients.

POSSIBLE CAUSES. Contraction through unprotected sex with multiple partners. Contact with contaminated towels.

SYMPTOMS PRODUCED IN MEN AND WOMEN. Asymptomatic- most of the time. Urethra discharge if present. Burning sensation. WOMEN Vagina discharge-green & smelly. Lower abdominal pain. Genital inflammation, itching/redness. Tissue erosion. Painful intercourse.

SYMPTOMS CONT. MALE May cause urethritis if left untreated. FEMALE May cause cystitis/ urethritis if left untreated.

TREATMENT. Metronidazole 2 grams. Has a 90% rate since it is given at once. It is also effective in treating male partners. Tinidazole.

PREVENTION Abstinence. Use protection when having intercourse. Limit sexual partners (recommendation-to one). Immediate treatment if infected & the partner also.

WORKS CITED en.wikipeda.org/wiki/trichomonas-vaginalis. www.cdc.gov/ncidod/eid/vol7no6/solvillo.htm. www.wdxcyber.com/drvagoo3.htm.

GROUP 5. CAROLINE MURAGURI, JULIET GARO & MAUREEN HORSCH.