This medical journal describe a case of persistent urethritis along with prostatitis that is caused by Trychomonas vaginalis (TV) in young male patients. As we know, trichomoniasis had been associated with urethritis and prostatitis as a highly prevalences worldwide in men. This infection may increase the risk of HIV acquisition. Some of studies stated this infection of Trichomonas vaginalis associated with elevated seminal HIV RNA in men with HIV infection and symptomatic urethritis. But the difficulties of diagnosis this infection had came into poorly understandings of how importance the tricomoniasis infection.
Clinical and laboratory diagnosis of trichomoniasis is more complicated in men. Urethral swab is considered to diagnose trichomoniasis in men, instead of urine or semen which will increase the sensitivity tests in results. This is because of the fact that TV can infect multiple sites of male genitourinary tract. Practically, it is possible to find the organism in one specimen but not in another when testing samples from the same individual. The other reason is about the number of organisms in male specimen cultures is very small and this number usually does not increase over the incubation period.
Numerous study described that the administer of metronidazol to male urethritis-trichomoniasis in common, showed not only eliminate the infection but may also reducing the transmission of HIV. But there is no opinion’s concensus in the therapies of prostatitis which is caused by TV.
Those experts assumed that the concurent treatment of patient’s partner(s) was unlikely because there was some evidence to suggest that the failure rate of a single dose is higher if partner(s) are not treated simultaneously. Thus, they did not administered neither a higher dose of metronidazole nor prolonged regimens because of the recent onset of prostatitis (so they did not put the infected patient in a chronic TV-prostatitis category). The signs and symtomps showed completely subside after therapy, but unfortunately they unable to prove TV eradication due to no follow-up cultures were conducted.
The patients with persistent or reccurent Non Gonococcal Urethritis seemed reperesent a high risk class for TV infection. They are called to repeat diagnostic evaluation-altough no infectious etiology has been found. These kind of patients often empirically subjected with multiple course of antibiotics.
Finally, the experts stated highlightly about the importance and necessity in performing accurate diagnostic along with persistent or reccurent urethritis. Therefore, collection of multiple spesimens from different part of genitourinary tract may have a strike point in increasing the sensitivity of TV tests in young male patients with negative outcomes by routine investigate methods.
The Author of this article were Alireza Abdolrasouli, BSc MSPH MSc,Abolghasem Amin, PhD, Manouchehr Baharsefat, PhD, Azita Roushan, BSc, and Shamseddin Mofidi, MD PhD from Clinical Research Unit, Department of Infectious Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom; Department of Clinical Microbiology, Marie-Curie Medical Institute;Department of Clinical Microbiology, Mehr Hospital, Teheran, Iran.
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