[Chronic trichomonas infections in the male. Their significance for fertility disorders].
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Tinidazole preparations are effective agents for the therapy of genitourinary trichomoniasis in women and men. The application of these drugs is very simple and, in particular, suitable as the application time is short and the occurrence of slight side effects shows a very low incidence. Unfortunately, these medicaments cannot be used during pregnancy and lactation. In addition, definite therapeutical recommendations are lacking and the published specific experiences in the therapy of obese persons with these drugs should be verified in future.
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The indirect hemagglutination (IHA) technique was evaluated for use in the serologic study of infection with Trichomonas vaginalis. The IHA test showed that sera from 88% of women attending a venereal disease clinic had antibody to T. vaginalis. The antibody frequency and titers were highest in women who had documented infections due to T. vaginalis. Serologic and cultural evidence of recent or active trichomonal infection was found in 11% of 85 men who had nongonococcal urethritis, but was absent in a control group of 27 men. Clinical findings in ten men with symptomatic genitourinary trichomoniasis are described; all but one had relatively high (greater than or equal to 1:80) IHA antibody titers. Antibody to T. vaginalis was found significantly (P less than 0.005) more often in sera from women than in sera from men in an apparently healthy group of individuals between the ages of 1 and 20 years. The IHA test appears potentially useful for the diagnosis of trichomoniasis in men and in the seroepidemiology of infections due to T. vaginalis.
Samples of semen and urine were obtained from 37 male contacts of women with proved Trichomonas vaginalis infection; on culture, eight (22%) of the men were shown to harbour the parasite. However, significant amounts of antitrichomonal antibody were found in only two of these samples, and the amounts present were very small. A further 10 samples were tested but none was found to contain antibody. The asymptomatic nature and low parasite numbers commonly described in infections in men is thus unlikely to be due to a vigorous local immune response.
Susceptibility of different strains of mice to infection with Trichomonas vaginalis was determined. Striking strain differences in susceptibility to T. vaginalis inoculum were observed in different mouse strains suggesting that susceptibility is under control of genes mapping mainly outside the major histocompatibility complex.
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Seventy-three men with urogenital trichomonal infection were treated with a single daily dose of 1 g tinidazole or 1.5 g metronidazole. Both treatments gave satisfactory results. Wives who were also infected with Trichomonas vaginalis, were less likely to have a recurrence of the infection after their husbands had been given either drug.
The acridine orange test for detection of Trichomonas vaginalis in smears has been adapted for delayed examination of specimens. Mailed-in slides stained by acridine orange were compared with on-site wet mounts; the acridine orange test detected 96% of all positives, whereas only 76% were detected by wet mounts. In a similar comparison with Papanicolaou smears, the acridine orange test detected 89% as compared with 67% detected by Papanicolaou smears.
The indirect fluorescent antibody test was used to detect antibodies to Trichomonas vaginalis in 200 antenatal patients. A total of 104 (52%) gave a positive reaction with antigen prepared from cultures of trichomonas isolated from seven of the patients. Antitrichomonal antibody was detected at a 1/4 dilution in 90% of patients with proven trichomoniasis, while the highest dilution at which antibody was detected was 1/32. IgG rather than IgM appeared to be the antibody class involved. Of those patients with no demonstrable trichomonal infection, 17% gave positive reactions at 1/4 dilution, while 64% had no demonstrable antibody. One of 30 children under 11 years of age gave a positive reaction.
A new anti-protozoal compound, ornidazole, a derivative of nitroimidazole, was given in a single 2 g dose to 20 women with Trichomonas vaginalis infection. All the women were cured, but they suffered some side-effects. Plasma levels of ornidazole reached a peak five to eight times higher than minimum inhibitory concentrations and exceeded this level for at least 36 hours. It is therefore possible that a smaller dose might have had an adequate trichomonicidal effect and fewer side-effects. Further studies are in progress.
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