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Try out PMC Labs and tell us what you think. Learn More. Vaginal discharge is a common complaint of women of childbearing age. Bacterial vaginosis, candidiasis and trichomoniasis are the three main causes of vaginitis. Sexual intercourse is believed to be the most common cause of transmission of trichomoniasis, but nonvenereal transmission of trichomonas can occur very rarely. A year-old female came to the hospital with complaints of vaginal discharge.

A cervical smear was taken and stained with Papanicolaou stain. The smear showed sheets of superficial and intermediate squamous cells with numerous pale grey, round to pear-shaped organisms with pale vesicular eccentric nuclei [ Figure 1a ] and intracytoplasmic faint red granules [ Figure 1a , inset]. Some of the organisms were seen adjacent to the squamous cells. Many cannon balls formed by adherence of neutrophils to the squamous cells were seen [ Figure 1b ]. Lactobacilli were absent. A diagnosis of trichomoniasis was suggested.

Trichomoniasis is caused by an anaerobic flagellate protozoan, Trichomonas vaginalis. This disease is more common at the period of greatest sexual activity. It was always believed to be a sexually transmitted disease. But, an extensive literature search showed that nonsexual transmission of trichomonas can occur through fomites like towels and toilet seats and from swimming pools.

The normal pH of the vagina is 3. The production of cell-detaching factors released by the parasite is found to decrease in the presence of estrogen. This is thought to be the reason for aggravation of the disease at the time of menses, when the estrogen levels are lowest. Charlotte Gaydos, the study investigator, said that women aged 50 years and older had the highest trichomonas infection rate in their study. In conclusion, there are reports to support nonvenereal transmission of trichomonas. But, further large-scale epidemiologic studies are needed to confirm this fact.

This should be borne in mind when sexually inactive older women present with vaginal discharge. Older postmenopausal women are prone to the trichomonas organism because of the change in their vaginal acidity and estrogen deficiency. Trichomonas should be ruled out as a possible cause of abnormal vaginal discharge among nonsexually active older women who are considered low risk. Testing for trichomonas should be considered in conjunction with other tests for bacterial vaginosis, candidiasis, etc.

National Center for Biotechnology Information , U. Author information Copyright and information Disclaimer. Address for correspondence: Dr. E-mail: moc. This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3. This article has been cited by other articles in PMC. Sir, Vaginal discharge is a common complaint of women of childbearing age.

Open in a separate window. Figure 1. Non-sexual transmission of trichomonas vaginalis in adolescent girls attending school in Ndola, Zambia. PLoS One. Meyer EA. Other intestinal protozoa and trichomonas vaginalis. In: Baron S, editor. Medical Microbiology. Chapter Adu-Sarkodie Y. Trichomonas vaginalis transmission in a family. Genitourin Med. Sood S, Kapil A. An update on trichomonas vaginalis. Indian J Sex Transm Dis. Prevalence of trichomonas vaginalis and coinfection with Chlamydia trachomatis and Neisseria gonorrhoea in the United States as determined by the aptima trichomonas vaginalis nucleic acid amplification assay.

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