7
Microbiology, inflammation, and Viral infections
Fig. 7.70 (A)
T ric h o m o n a s v a g in a lis
various morphological forms. LBGS (Papanicolaou x MP). (B)
Trichom onas vaginalis
organisms have been stained
with mouse
anti-Trichom onas vaginalis
monoclonal antibody and immunoenzymatic technique. Note the varied forms of the organisms in this picture.
Vaginopancervical smear (IP x MP).
Fig. 7.71
T ric h o m o n a s v a g in a lis
organisms within the metaplastic
endocervical cells. Vaginopancervical smear (LBGS x MP).
Histologically, the organisms, although inconspicuous in
routine hematoxylin and eosin-stained cervical tissues, may be
detected by PAS, Masson's trichrome, and appropriate immuno-
diagnostic techniques.1253 They often occur on the surface of
both squamous and endocervical epithelial cells but may be
seen within the epithelial cells (Fig. 7.71) especially in the LBGS.
Pericellular ("chicken wire") edema may occur among the squa-
mous epithelial cells. Reserve cell hyperplasia, squamous meta-
plasia, and epithelial papillomatosis with capillary proliferation
may occur. Some of these changes may be nonspecific in nature
but are often seen in cases of trichomoniasis.
Although reactive and atypical epithelial cellular changes may
occur with
Trichomonas
, there is no convincing evidence of pure
T. vaginalis
infection causing nuclear chromosomal changes
or aneuploidy, and thus dysplasia or preneoplastic epithelial
changes. Concomitant infection with
Chlamydia,
herpes, and
HPV, among others, may occur in cases with
T. vaginalis
infec-
tion. There is some evidence for suspecting the presence of
Chlamydia
within
T. vaginalis
organisms. Bare nuclei, degenerated
Fig. 7.72
E n te ro b iu s v e rm ic u la ris
eggs. Vaginopancervical smear
(Papanicolaou x MP).
neutrophils, and mucus fragments must be distinguished from
trichomonads.
Enterobius vermicularis
Enterobius vermicularis
is a nematode commonly found in the
tropics. Although alimentary tract infection is common, occa-
sional reports exist of its occurrence in the endometrium,
fallopian tubes, and other sites. Most often the eggs of
E. ver-
micularis
occur as a contaminant in vaginal pool material, espe-
cially among women with poor personal hygiene. These eggs are
50-60 pm by 20-25 pm. They are flattened on one side (Fig.
7.72). The shell is double-walled and smooth. Within the egg,
an embryo can often be recognized. Only rarely may the larvae
be seen in the vaginal smear (Fig. 7.73).
Trichuriasis
This is a nematode infection caused by
Trichuris trichiura.
The
eggs of this alimentary tract parasite may occur in the vaginal
smear as a contaminant. The eggs are barrel shaped and 50-
55 nm by 20-25 nm. They have a thick shell with a brownish
125
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