Laboratory and clinical studies on vaginal trichomoniasis

Abstract

1.1. The present report is based upon a series of clinical and laboratory studies during the past 3 years on women with vaginal trichomoniasis, before, during, and after treatment of the infection, in an endeavor to furnish information on alterations attributable to T. vaginalis.2.2. Over half of the patients when first seen had mild to severe inflammation of the vaginal introitus but not necessarily of the vaginal vault.3.3. Even though the majority of the patients had not been sufficiently disturbed by their vaginal symptoms to consult a physician prior to joining the study, nearly every patient who was followed over a period of several months had one or more episodes of mild to marked inflammation of the vaginal introitus which was almost invariably accompanied by increased itching or other sensations. This amounted to a definite clinical vaginitis in 40 per cent of the patients which, however, usually improved after a few days even without treatment.4.4. Calculation of the fluctuations in per cent of cornified cells during menstrual cycles failed to demonstrate any marked difference between women with or without T. vaginalis and did not show evidence of an increased percentage of cornified cells in women with vaginal trichomoniasis.5.5. Administration of trichomonacidal and fungicidal medication, however, resulted in an increased per cent of cornified cells which was most pronounced and persisted the longest with vaginal Aureomycin.6.6. A greater proportion of vaginal smears from women with moderate to severe vaginitis had deep cells and intense leukocytosis than those from women without such an inflammation, but there was no particular difference between women with or without T. vaginalis.7.7. The per cent of vaginal cells containing glycogen was appreciably lower in women with T. vaginalis than in women from whom the parasite had been eradicated and was even higher in the women who had never had such an infection.8.8. Grade I bacterial flora was observed in only 12 per cent of vaginal smears from patients with T. vaginalis. Lactobacillus was, however, cultured from approximately 50 per cent of such patients.9.9. Following cure of trichomoniasis, a great many more smears were of Grade I type but cultures with Lactobacillus were not appreciably increased.10.10. Cultures of vaginal secretion showed little difference between patients with T. vaginalis with minimal or absent vaginitis and women without T. vaginalis, except that the latter had a much higher proportion of Lactobacillus. Cultures from patients with T. vaginalis vaginitis, however, had a much higher proportion of nonhemolytic Staphylococcus albus and Group D Streptococcus than either of the other groups of women.