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The aim of this study was to evaluate different methods for Trichomonas vaginalis diagnosis during pregnancy in order to prevent maternal and perinatal complications. A total of 386 vaginal exudates from pregnant women were analyzed. T. vaginalis was investigated by 3 types of microscopic examinations direct wet mount with physiologic saline solution, prolonged May-Grunwald Giemsa (MGG) staining, and wet mount with sodium-acetate-formalin (SAF)/methylene blue method. PCR for 18S rRNA gene as well as culture in liquid medium were performed. The sensitivity and specificity of the microscopic examinations were evaluated considering the culture media positivity or the PCR techniques as gold standard. The frequency of T. vaginalis infection was 6.2% by culture and/or PCR, 5.2% by PCR, 4.7% by culture, 3.1% by SAF/methylene blue method and 2.8% by direct wet smear and prolonged MGG staining. The sensitivities were 83.3%, 75.0%, 50.0%, and 45.8% for PCR, culture, SAF/methylene blue method, and direct wet smear-prolonged MGG staining, respectively. The specificity was 100% for all the assessed methods. Microscopic examinations showed low sensitivity, mainly in asymptomatic pregnant patients. It is necessary to improve the detection of T. vaginalis using combined methods providing higher sensitivity, such as culture and PCR, mainly in asymptomatic pregnant patients, in order to prevent maternal and perinatal complications.

Infections of the lower genital tract associated to maternal and perinatal complications frequently occur during pregnancy. The aim of this study was to evaluate vaginal dysfunction through the analysis of basic vaginal states (BVS) using the methodology of balance of the vaginal content (BAVACO) and to compare it with the microbiological study of candidiasis, trichomoniasis and bacterial vaginosis (BV). Pregnant patients (1238) were examined from 2010 to 2012. In asymptomatic (A) (n: 1046) and symptomatic pregnant women (S) (n: 192) BVS I was 59.5% and 26% of the patients, respectively. BVS II was observed in 19.7% of A and in 17.2% of S. BVS III was only detected in A in 0.4%. BVS IV was observed in 14.4% of A and in 38% of S. BVS V was detected in 6% of A and in 18.8% of S. Yeasts were associated to BVS I and II in 55.5% and 23.2% of A, respectively; and in 32.4% and 31% of S, respectively. Trichomonas were associated to BVS I in 50% of A, to IV in 44.4% of S and to V in 33.3% of S. BAVACO susceptibility to detect yeasts was 80.4% and 85.5% in A and S, respectively; 40% and 75% in A and S, respectively, to detect trichomonas and 100% in A and S to detect BV. BAVACO specificity was 100% for all pathogens in A and S. The study of BVS proved useful as a guide to evaluate vaginal dysfunction, regardless of symptomatology. Therefore, this study is recommended as prenatal control.

Acanthamoeba sp. keratitis is generally related to wearing contact lenses, and, to a lesser extent, to contaminated water. It is characterized by reduced visual capacity and the presence of severe ocular pain. Clinically, it can be mistaken for a herpes infection. if it is not diagnosed, and timely and adequately treated, it can result in corneal perforation and, eventually, in vision loss. One of the few registered cases of Acanthamoeba sp. keratitis not related to the use of contact lenses is herein reported.

The presence of numerous trypomastigote forms of Trypanosoma cruzi in the pleural fluid of a patient with AIDS from Santiago del Estero, Argentina, was detected. Chagas disease is endemic in some countries of Latin America. To our knowledge, the finding of trypomastigote forms of T. cruzi in the pleural fluid has not yet been described in the literature.

Resumen Se detecto la presencia de numerosos tripomastigotes de Trypanosoma cruzi en el liquido pleural de un paciente con SIDA proveniente de Santiago del Estero, Argentina. La enfermedad de Chagas es endemica en algunos paises de America Latina. Segun nuestro conocimiento el hallazgo de tripomastigotes de T. cruzi en el liquido pleural no ha sido previamente descrito en la literatura medica. Referencias 1.- Del Castillo M, Mendoza G, Oviedo J, Perez Blanco R P, Anselmo A E, Silva A M. AIDS and Chagas disease with central nervous system tumor-like lesion. Am J Med 1990; 88: 693-4.2.- Rocha A, Oliveira de Meneses A C, Moreira da Silva A, Ferreira M S, Nishioka S A, Burgarelli M K N, et al. Pathology of patients with Chagas disease and acquired immunodefi ciency syndrome. Am J Trop Med Hyg 1994; 50: 261-8.3.- Lopez M O. Meningoencefalitis chagasica en un paciente con infeccion por VIH/SIDA con sobrevida a tres anos: Caso clinico. Rev Chil Infectol 2010; 27: 160-4.4.- Iliovich E, Lopez R, Kum M, Uzandizaga G. Peritonitis espontanea chagasi-ca en un enfermo de SIDA. Medicina (Buenos Aires) 1998; 58: 507-8.5.- Ferreira M S, Nishioka S de A, Silvestre M T A, Borges A S, Nunes Araujo F R, Rocha A, et al. Reactivation of Chagas disease in patients with AIDS: report of three new cases and review of the literature. Clin Infect Dis 1997; 25: 1397-400.6.- Corti M. Enfermedad de Chagas y sindrome de inmunodefi ciencia adquirida. Enf Emerg 2003; 5: 13-7.7.- Sartori A M, Sotto M N, Braz L M, Oliveira Junior Oda C, Patzina R A, Barone A A, et al. Reactivation of Chagas disease manifested by skin lesions in a patient with AIDS. Trans R Soc Trop Med Hyg 1999; 93: 631-2.8.- Concetti H, Retegui M, Perez G, Perez H. Chagas’ disease of the cervix uteri in a patient with acquired immunodefi ciency syndrome. Hum Pathol 2000; 31: 120-2.9.- Cordova E, Boschi A, Ambrosioni J, Cudos C, Corti M. Reactivation of Chagas disease with central nervous system involvement in HIV-infected patients in Argentina, 1992-2007. Int J Infect Dis 2008; 12: 587-92.Figura 2. Tripomastigotes de