A patient presented with ‘Frothy’, greenish vaginal discharge with a ‘musty’ malodorous smell.Pap Smear shows the following abnormality.What would be the treatment of choice?
Pap Smear shows Trichomonas Vaginalis Infection.: Numerous organisms free and feeding on squamous cells .
Cytopathology of Trichomonas Vaginalis Infection
- Low power: grey blob with a nucleus, may be pear-shaped:
- Size: approximately 30 micrometres.
- Shape: usually oval, may have teardrop-shaped.
- Flagellum – hair-thin locomotive stucture, usu. barely visible at 200X – diagnostic feature.
- Acute inflammation (neutrophils), often marked – key feature at low power.
- Reactive squamous cells with:
- Perinuclear halos, and
- Moth-eaten cytoplasm; cytoplasm that has multiple vacuoles with star-like spaces.
- Trichomonas is tricky – it is easy to miss if one is not suspicious, in the context of inflammation.
- May vaguely resemble a neutrophil:
- Flagellum useful to differentiate.
- Neutrophil has multiple lobulations of the nucleus.
- May be seen in association of Leptothrix.
- Appearance: long, hair-like.
- Size: ~0.5 x 20 micrometres.