Focus on pathogen: T' vaginalis diagnosisID

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Focus on pathogen T. vaginalis diagnosis/ID

• Morphology of troph general overall pear shape,
  10-23uM, with protruding axostyle on pointed end,
  4 flagella in a group on opposite end near an
  obvious dark-staining nucleus, and an undulating
  membrane down the side. Troph may round-up in
  hypotonic urine and resemble WBCs.
• Very active, rhythmic, jerky, non-directional
  motility due to 4 anterior flagella and
  undulating membrane extending from the rounded
  anterior end to half-way down the body-length. A
  5th flagella may aid in direction.
• No other protozoa in urogenital specimens to be
  confused with T. vaginalis

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Non-pathogenic flagellates

• Trichomonas hominis
• Chilomastix mesnili

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Trichomonas hominis

• T. hominis morphologically closely resembles T.
  vaginalis. The difference lies in the position
  of the undulating membrane on the side of the
  cell
• a)T. hominis the undulating membrane begins
  at the nuclear end and ends near the pointed end.
• b)T. vaginalis the undulating membrane begins
  near the nucleus but ends somewhere midway
  between the nucleus and the pointed end.
• This membrane is very thin which makes it
  difficult at times to use as a diagnostic too,
  so...

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Trichomonas hominis

• The similar morphology will not lead to
  misidentification because T. hominis does not
  inhabit the urogenital tract and T. vaginalis
  cannot survive in feces.
• Motility of the two species are quite different,
  which almost assures the two will not be
  confused
• a) T. hominis darts rapidly in wet mounts of
  feces
• b) T. vaginalis has jerky movements in
  urogenital specimens

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Trichomonas hominis
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Chilomastix mesnili

• Commensal nonpathogenic intestinal flagellate
• Diagnostic features of troph in permanent stains
  and wet preparations
• Size 6-20uM long, 5-15uM wide
• Round on one end, tapered to a point on the other
• Single nucleus on round end
• peripheral chromatin may be visible
• karyosome may be central or eccentric
• may contain radiating chromatin filaments or may
  have granular appearance orbiting karyosome

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Chilomastix mesnili

• MORE Diagnostic features of troph in permanent
  stains and wet preparations
• Cytostome emanating from round end near the
  nucleus and extending over half of body length
• Cytoplasm usually vacuolated
• Three flagella emanating from oral end and one in
  cytostome (difficult to see except in wet preps)
• Motility (wet prep) stiff and rotary Debbie?

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Chilomastix mesnili

• Diagnostic features of cyst in permanent stains
  and wet preparations
• Size 6-10uM long, 4-6uM wide
• Morphology
• Lemon shaped oval with a knob or handle on
  one end
• Single nucleus similar to one in troph
• Curved fibril resembling a shepherds crook

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Chilomastix mesnili
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Blood and tissue protozoans

• Sarcodina
• Naegleria fowleri Acanthamoeba
  species
• Mastigophora
• Trypanosoma (circ), Leishmania (circ),