Pathogenesis

Table 15.1 Significant relationships between clinical findings and numbers of protozoa per 400 x field in 67 wet mounts from women with trichomoniasis

Manifestations

Mean number of protozoa when manifestation

Present

Absent

Symptoms

Yellow discharge Signs

0.04

Strawberry cervix Increased discharge Purulent discharge

Source: Wolner-Hanssen et al., unpublished data.

Genital erythema 14.7±17.7 8.4±13.8

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Production of cell detaching factor does correlate with clinical presentation of trichomoniasis (Garber et al. 1989). The capability to produce subcutaneous abscesses in mice, haemolytic activity, and adherence to HeLa cells have also been regarded as markers of T. vaginalis pathogenicity. However, the clinical manifestations most strongly associated with trichomoniasis (colpitis macularis and yellow discharge), do not correlate with these features (Krieger et al. 1990b). Moreover, wet mounts are more often positive in women with symptomatic than in those with asymptomatic trichomoniasis (Krieger et al. 1990a). As shown in Table 15.1, the concentration of T. vaginalis in vaginal fluid is related to severity of signs and symptoms of inflammation (P. Wolner-Hanssen, unpublished data).

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