Further studies on trichomonas vaginalis (donné)

Abstract

The cultures confirmed the findings of direct smear examinations although the relative number of the various organisms was affected by culturing. Döderlein bacillus grows very scantily, and the gram-positive nonhemolytic streptococcus cultures luxuriantly. No group of strict anaerobes was found, although the gram-positive streptococcus and the gram-negative bacillus grew readily under anaerobic as well as aerobic conditions. The only organisms found with any degree of consistency in all patients with Trichomonas vaginalis vaginitis were the Döderlein bacillus and the gram-positive nonhemolytic streptococcus. These organisms were likewise found in about the same proportions in all cases in which no Trichomonas vaginalis were found. The streptococcus, in agreement with the experience of Curtis, appeared in a diplococcic form in direct smear examination and was either oval or lancet-shaped. It formed chains when grown on artificial culture media.A number of streptococci isolated from our cultures were subcultured in sugar (lactose, mannite, salicin, and saccharose) and according to Holman's9 classification, belonged to the following groups: Streptococcus ignavus, Streptococcus salivarius, and Streptococcus nonhemolyticus III. Other bacteria found less consistently in both groups were B. coli, a staphylococcus, B. mucosus, diphtheroids, a small gram-negative diplococcus (not gonococcus), a small gram-negative bacillus not of the typhoid-coli group, a thin gram-negative bacillus (Vibrio), a large gram-positive spore-bearer, and one large gram-positive hemolytic streptococcus. No cases with gonorrheal infection were found among the group with Trichomonas vaginalis vaginitis and none were used for control cases.Direct smear examination, verified by cultures, revealed the presence of yeasts in only 6 of our 59 patients. One of these had Trichomonas vaginalis vaginitis; another had a previous history of trichomonas, but she was apparently cured; 2 had Trichomonas vaginalis vaginitis complicating pregnancy; and 1, who showed no evidence of trichomonas infection, had a profuse leucorrhea. It is apparent from this study that yeasts were not responsible for the vaginitis in the group of women under our observation. It is also obvious that inasmuch as the same group of bacteria was found in the vaginal secretion in the presence of Trichomonas vaginalis as in that without the parasite, the flagellate is responsible for the altered clinical picture.From our clinical and laboratory studies of more than one hundred cases of Trichomonas vaginalis vaginitis over a period of approximately eighteen months, we believe the following conclusions may be drawn: