Case #512 – March, 2020
A 29-year-old female patient presented to her primary care physician reporting a 15-day history of whitish, vaginal discharge associated with itching. She also complained of lower abdominal pain. A vaginal, speculum examination revealed an inflamed cervix with red, punctate lesions. A Pap smear collected at the time of examination was sent to the pathology lab for a Papanicolaou stain. Figures A and B show what the pathologist observed using an oil immersion objective. The objects of interest measured 10-15 µm long. What is your diagnosis? Based on what criteria?
Case and images courtesy of Dr. Prasad, Professor of Pathology, Sri Devaraj Urs Medical College, Kolar-563101, Karnataka, India
This is a case of trichomoniasis caused by the protozoan Trichomonas vaginalis. Diagnostic features included:
- Pear-shaped organism (trophozoite) with several flagella projecting anteriorly and a single flagellum observed at the opposite end.
- A large nucleus with an eccentric karyosome (Figure A).
- Organism approximately 10 x 7µm within the size range for Trichomonas vaginalis.
More on: trichomoniasis
Images presented in the dpdx case studies are from specimens submitted for diagnosis or archiving. On rare occasions, clinical histories given may be partly fictitious.
DPDx is an educational resource designed for health professionals and laboratory scientists. For an overview including prevention, control, and treatment visit www.cdc.gov/parasites/.