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Trichomonas vaginalis is the most common nonviral sexually transmitted infection. According to the 2019 WHO cancer report, cervical cancer is the fourth most frequent cancer in women. However, previous research, which has not included a large-scale study to date, has revealed that Trichomonas vaginalis increases cervical cancer risk. In this study, we investigated a group of Asian females in Taiwan to determine the association between trichomoniasis and the risk of developing cervical lesions, including cancer, neoplasm, and dysplasia. We conducted a nested case-control study by using the National Health Insurance (NHI) program database in Taiwan. The International Classification of Diseases, 9th Revision classifications (ICD-9-CM) was used to categorize all of the medical conditions for each patient in the case and control groups. The adjusted odds ratio (AOR) and 95% confidence interval (CI) for the association between trichomoniasis and cervical lesions were estimated using multivariable conditional logistic regression to adjust for all comorbidities and variables. In total, 54,003 individuals were enrolled in the case group and 216,012 were enrolled in the control group. Trichomonas vaginalis exposure had a significant association with cervical lesions (AOR 2.656, 95% CI = 1.411-5.353, p = 0.003), especially cervical cancer (AOR 3.684, 95% CI = 1.622-6.094, p = 0.001). In patients with both trichomoniasis and depression, the relative risk increased 7.480-fold compared to those without trichomoniasis or depression. In conclusion, female patients with Trichomonas vaginalis exposure had a significantly higher risk of developing cervical lesions (especially cervical cancer) than those without exposure.

A 32-year-old lady came for a routine gynecological check up. Her cervical cytologic smear was reported as low grade squamous intraepithelial lesion. As a part of basic routine investigation, cervical punch biopsy was done. Astonishingly it revealed multiple rhabditiform larvae of Strongyloides stercoralis. These were curved thick with pointed end and a short buccal cavity. She did not have any history of immunosuppression including steroid therapy and was otherwise normal. Extensive review of the literature on parasites encountered in cervix yielded few case reports on strongyloides in cytologic smears, but failed to reveal any report till date on S. stercoralis found in histopathology section. Our case is probably the first in the world and the first reported from India to the best of our knowledge. We describe this case of strongyloidiasis of cervix with review of the literature on various parasites encountered in the cervix because of its rarity and also to keep this parasitic infestation as a differential diagnosis of cervical lesions.

Schistosomiasis mansoni is found in different endemic areas of Brazil. It is a serious public health problem in Brazil and worldwide. Ectopic forms of the disease may affect the female reproductive system, representing a rare type of Schistosoma mansoni infection. A 26-year-old patient complained of vaginal discharge, dyspareunia and pain on palpation of the hypogastrium. Gynecological examination revealed an endocervical polyp. A biopsy was performed. Under microscopy, several granulomas surrounding degenerate and viable eggs of Schistosoma mansoni were seen. Treated with praziquantel, she was asymptomatic after four weeks of treatment. Vaginal discharge and dyspareunia may be secondary causes of cervicitis caused by Schistosoma mansoni. The search for eggs in routine vaginal smear or histological examination should be part of the gynecologic evaluation of patients from endemic areas, with the purpose of tracking ectopic schistosomiasis of the female genital tract.

Hydatid disease is an endemic infection which can affect any organ, mainly the liver and lungs. Peritoneal echinococcosis is usually known to occur secondary to hepatic hydatid cyst rupture into the peritoneal cavity. An isolated cyst in the pelvic cavity is considered as primary only when there are no other hydatid cysts. Herein, we report an isolated pelvic-cervical hydatid cyst which presented without any involvement of the other abdominal organs or lungs. Our patient, a 27-year-old woman with the primary complaints of dyspareunia and chronic pelvic pain, had thin-walled large cystic mass originating from the cervix, diagnosed by ultrasonography. She underwent surgery with the most likely initial diagnosis of exophytic fibroid with cystic degeneration. Gynecologists should be aware of the possibility of isolated primary hydatid cyst of the pelvic cavity and should consider this condition in the differential diagnosis of cystic pelvic masses, especially in areas where the disease is endemic., (© 2014 The Authors. Journal of Obstetrics and Gynaecology Research © 2014 Japan Society of Obstetrics and Gynecology.)

Objective: Cervical cancer is one of the most common malignancies worldwide, yet it is preventable by population screening. In a previous study, we confirmed the feasibility of utilizing whole slide imaging (WSI) of cell block (CB) preparations to overcome the limitations of digitizing cytologic samples. In this study, we evaluated the accuracy of WSI in identifying various organisms and nonneoplastic findings., Study Design: A total of 335 WS images from Pap CB preparations were analyzed using the Aperio system. The test performance characteristics of ThinPrep (TP) and WSI samples were compared for adequacy, for the presence of bacterial vaginosis (BV), fungi, Trichomonas vaginalis (TV) and herpes simplex virus (HSV) and for nonneoplastic findings., Results: The WSI samples contained optimal material from all preparations. BV was diagnosed in 33 WSI versus 36 TP samples. Budding yeasts and/or pseudohyphal forms were noted in 18 WSI versus 19 TP samples. TV organisms (10 of 11 samples) and 1 HSV case were accurately identified in the WSI and TP samples. Squamous metaplasia, keratosis and reactive/reparative and inflammatory changes were easily identified by WSI., Conclusions: The concept of WSI from Pap CB preparations is potentially feasible for adoption. Digital remote web-based technology eliminates the need for an individual on site, saving time and resources., (© 2014 S. Karger AG, Basel.)

Introduction: Mansonella perstans is a genus of filaria that is often asymptomatic or responsible for unspecific symptoms. M. perstans microfilariae are uncommon on cervicovaginal smears., Case: We report the case of a woman with pruritis and eosinophilia. Microfilariae of M. perstans were observed on both cervicovaginal and blood smears. The patient was successfully treated with a combined single dose of 400 mg of albendazole and ivermectin (150 μg/kg)., Conclusion: We described here an atypical and rare localization of M. perstans. The routine examination of cervicovaginal smears of women admitted to Bobo-Dioulasso Hospital for screening of cervical neoplasia should allow us to determine the frequency of this parasitosis and propose appropriate treatment.

Background: Schistosomiasis remains a major threat to women's health in many resource-poor countries and is being seen with increasing frequency in developed countries among immigrants and tourists who have a history of freshwater exposure in endemic areas., Case: A 28-year-old asymptomatic African immigrant presented with an abnormal Pap test result showing rare atypical squamous cells. Colposcopy examination showed pale-yellow, finely granular cervical lesions. Calcified Schistosoma hematobium eggs were identified by histology but were absent in urine and stool specimens. Praziquantel treatment was initiated promptly, avoiding significant morbidity., Conclusion: The differential diagnosis of female genital schistosomiasis should be considered for patients who have a history of residence in or travel to endemic areas, including asymptomatic patients and patients presenting a long time after exposure.

Background: Sexually transmitted infections (STIs) are associated with an increased risk of HIV infection. To model the interaction between STIs and HIV infection, we evaluated the capacity of the pigtail macaque model to sustain triple infection with Trichomonas vaginalis, Chlamydia trachomatis, and SHIV(SF162P3)., Methods: Seven SHIV(SF162P3) -infected pigtail macaques were inoculated with T. vaginalis only (n = 2), C. trachomatis only (n = 1), both T. vaginalis and C. trachomatis (n = 2), or control media (no STI; n = 2). Infections were confirmed by culture and/or nucleic acid testing. Genital mucosa was visualized by colposcopy., Results: Characteristic gynecologic signs were observed for both STIs, but not in control animals. Manifestations were most prominent at days 7-10 post-infection. STIs persisted between 4 and 6 weeks and were cleared with antibiotics., Conclusions: These pilot studies demonstrate the first successful STI-SHIV triple infection of pigtail macaques, with clinical presentation of genital STI symptoms similar to those observed in humans., (Published 2011. This article is a U.S. Government work and is in the public domain in the USA.)

To estimate the prevalence of sexually transmitted infections (STI) and lower reproductive tract infections (RTI) and determine risk factors for STI among rural women in Sichuan Province, China, a cross-sectional, community-based cluster sample of 2,000 rural, married women were interviewed, examined and clinical specimens collected to assess for six STI and two non-sexually transmitted RTI. The overall prevalence of any STI was 10.9% (95% CI 9.5-12.3); of any STI or RTI was 30.8% (95% CI 28.7-32.8). Chlamydia trachomatis was detected in 6.4% of women, Neisseria gonorrhoeae in 1.7%, Treponema pallidum in 0.5%, human papilloma virus in 0.6%, herpes simplex virus type-2 in 2.0%, Candida albicans in 8.8%, Trichomonas vaginalis in 0.7% and bacterial vaginosis in 15.4%. The reported low risk sexual behavior was corroborated by the prevalence of STIbased on laboratory findings. The prevalence of Chlamydia trachomatis alone and the combined prevalence rates of Neisseria gonorrhoeae and Chlamydia trachomatis were high enough (7.9%) to consider interventions for the control of cervical infections. Health promotion messages regarding safe sexual and health care seeking behavior is important. Routine STI surveillance, including prevalence studies, which provide accurate information for decision-making should be continued as an essential component of good STI control.

Myiasis is the infestation of the tissues of vertebrate animals by the larvae of flies (maggots). As the condition generally occurs in exposed areas of the body, genital myiasis is a rare condition, and myiasis of the uterine cavity is even rarer, only one case having been previously described in the literature. The case reported here describes myiasis of the uterine cavity and ulcerated vaginal mucosa of an 89-year-old woman with a severe (third-degree) genital prolapse. This case describes an extremely rare situation, and emphasizes the need for good hygiene and surgical correction in patients with a genital prolapse.

The Pap smear has been in use for more than half a century as the primary screening test for preinvasive and invasive lesions of the uterine cervix. Although not the primary use and an imperfect test, it can be extremely useful in the diagnosis of some microorganisms. This review focuses on the use of the Pap smear in the diagnosis of several microorganisms including Actinomyces, Chlamydia trachomatis, Candida, Trichomonas vaginalis, Leptothrix vaginalis, Herpes Simplex Virus, the causative agents of bacterial vaginosis, and other rarer organisms. The accuracy of diagnosis using the smear varies among the different organisms in question.

Genital manifestations in schistosomiasis haematobium are common and are associated with considerable morbidity. Although Schistosoma mansoni may also cause genital disease, the frequency of this complication is not known. Cervical biopsies (N=401) and Pap smears (N=981) were therefore collected from women living in two S. mansoni-endemic areas (in the states of Alagoas and Ceará, in north-eastern Brazil). The women were screened for the presence of sexually transmitted diseases and for the presence, in their cervical smears and/or biopsies, of S. mansoni eggs. Attempts at schistosomiasis control, which began in both study areas in 1977, have led to generally low intensities of infection (<30 eggs/g faeces in 99% of infections) and community prevalences of infection that range between 1% and 52%. As no schistosome ova were detected in any of the biopsies or smears, it appears that the risk, among women, of genital manifestations of S. mansoni infection is small in areas where the parasite load in the population is low (as the result of interventions to control intestinal schistosomiasis).

We report the case of an asymptomatic 38-year-old woman that sought medical assistance due to infertility. The gynecological examination showed an endocervical polyp measuring 1.0 x 0.8 x 0.5 cm. A biopsy was performed. Under microscopy, several granulomas containing eggs of Schistosoma mansoni were seen.

A 37-year-old woman, originally from South Africa, presented for a gynecologic examination. Speculum examination revealed a friable cervical lesion. Both the cervical smear and biopsy contained intact, viable schistosome eggs consistent with those of Schistosoma haematobium. Appropriate treatment was initiated promptly, avoiding significant morbidity. The diagnosis of female genital schistosomiasis must be considered when the patient has a history of travel to or residence in endemic areas.

Parasites other than Trichomonas vaginalis may occasionally present in Pap tests obtained during gynecologic examination. We present a case of Loa loa found on a Pap test from an apparently healthy 19-yr-old woman who had immigrated to the US at the age of 15 from Cameroon. We discuss the cytologic features from this case and then briefly review Loa loa and the presence of parasites in Pap tests and other cervicovaginal specimens., (Copyright 2003 Wiley-Liss, Inc.)

Background: Female genitourinary schistosomiasis (FGS) is widespread in endemic areas causing significant morbidity and mortality. Recent data suggest that FGS of the cervix not only is considered a risk factor for contracting different sexually transmitted diseases (STD), but also plays a significant role in modifying the natural history and immunological response to those infections, in particular HIV and HPV., Case Report: A 32-year-old female from Zambia, who was recently diagnosed with HIV and high-grade dysplasia with koilocytosis on cervical Pap smear, underwent cervical conization which confirmed moderate cervical dysplasia and also revealed the presence of viable and nonviable schistosoma eggs in cervical stroma. Four different HPV types were isolated by PCR, including one "low-risk" (type 6) and three "high-risk" types (types 45,56, and 58)., Conclusion: The presence of HPV, HIV infection, and cervical schistosomiasis in our patient is likely more than coexistence of multiple agents in the same milieu as cervical schistosomiasis increase susceptibility for other STDs including HIV and HPV. Therefore, in patients with schistosomiasis, immediate treatment for schistosomiasis and additional testing for HIV and HPV is warranted.

Granulomatous inflammation of the cervix uteri is a common manifestation of infection with Schistosoma haematobium. In women the cervix is the most common site of infection by S. haematobium. Three methods were used to assess the performance of three different ways of detecting schistosome eggs in cervical tissue: cytological examination of a cervical smear, histological examination of a cervical biopsy, and direct examination of cervical tissue obtained by forceps biopsy (quantitative compressed biopsy technique [QCBT]). Of 228 women studied who lived in an S. haematobium endemic area in Tanzania, 112 (49%) had schistosome eggs detected in the cervix using QCBT. Histological examination detected eggs in 40 of 228 (18%). The cytological examination of cervical smears yielded only 6 positive results (3%). The median egg load in the cervical tissue of cases correctly diagnosed by histology was significantly higher than the egg load in the misclassified cases, indicating that the sensitivity of histological sectioning increases with egg density. We conclude that the QCBT is the diagnostic test of choice for schistosomiasis of the genital cervix.

A 28-year-old, lactating woman came for a routine checkup. Her cytologic smear revealed a single larva of Strongyloides stercoralis. On reviewing the literature on parasites encountered in cytologic smears, S stercoralis was found to be extremely rare. Our case is probably the second in the world and the first reported from India. A review of the literature on various parasites encountered in the cytologic smear is presented.

Four virgin beef heifers were inoculated intravaginally with 7 x 10(6) Tritrichomonas foetus organisms. Protozoal colonization of the vagina, cervix, and uterus developed within the first week after inoculation. Protozoa were no longer detected in secretions from these regions at approximately the same time in each heifer. Trichomonads were detected in reproductive tract secretions for 13 to 28 weeks. Eight weeks after clearance of trichomonads from the reproductive tract, a second infection was established in 2 of the 4 heifers by intravaginal inoculation of T foetus. The second infections were maintained for up to 4 weeks. The diagnostic sensitivity of wet-mount examination of the reproductive tract secretions was 30%, compared with 78% for culture of trichomonads in secretions. Collection and culturing of specimens of cervical and vaginal mucus provided the most reliable method for diagnosis of trichomoniasis during induced infection of heifers.

Egg morphology of Schistosomes affecting man in Africa is described and illustrated with particular reference to the appearance of the ova of S. haematobium, S. mansoni and S. mattheei in Papanicolaou stained smears.