Agen Parasitik Penyebab

Gangguan Sistem
Reproduksi
Forman Erwin Siagian
Departemen Parasitologi
FKUKI
Email: formanerwin@yahoo.com

5 tahap pemenuhan
kesehatan

Scope of
discussion
Candida spp
Trichomonas
vaginalis
Toxoplasma
gondii
Wuchereria
bancrofti
Pthirus pubis

Concepts

Vulvoaginitis symptoms may include:

oChange in color, odor or amount of
discharge from your vagina
oVaginal itching or irritation
oPain during intercourse
oPainful urination
oLight vaginal bleeding or spotting

Vulvovaginal Candidiasis
(VVC)

Size of the problem

55% of women by age mid 20s have
had VVC Geiger AM, Foxman B, Gillespie BW. AmJ Pub Hlth
1995;85:1146-1148.

Up to of all women at least 1 lifetime

episode
$58.4 million per year $19.8 in
medication costs Foxman B, et al STDs 2000;27:230-235.

Consequences
Not directly life threatening but can
caused ..
Poor self esteem.
Psychosexual problems.Stewart DE, Whelan CI, et al

Obstetrics & Gynecology 1990;76 :852-856. Irving G et al. STIs. 74(5):334-8,

1998 Oct. 99210932

Socially unacceptable to discuss

Often misunderstood/dismissed by
health professionals

Causative agent
C. albicans 85-90%
C. glabrata 5-10%
Others: C.tropicalis, C.krusei, C. kefyr,

Cassone et
al.
Infect.
Immun.
2007, 75(10):

Recurrent VVC (RVVC)

defined as 4 or more symptomatic infections per
year or 3 episodes not related to the administration
of antibiotics occurring within a year.
Recurrent disease occurs in 5% of women, and in
the majority of cases recurrence occurs within 3
months of the initial infection.
Between 10% and 33% of recurrent candidal
vulvovaginitis is due to species other than C
albicans, such as Candida glabrata (the most
common), Candida tropicalis, Candida krusei,
Candida parapsilosis, and Saccharomyces cerivisiae.

Theories about RVVC

based on the intestinal reservoir of Candida
species, though this has not been demonstrated in
subsequent studies,
sexual transmission, as 20% of sexual partners
have colonization of the mouth, genitalia, and fingers
by the same species.
The most widely accepted theory at the present time
is that recurrent candidal vulvovaginitis is due more
to persistence of the pathogen in the vagina
than to reinfection; this is supported by the isolation of
microorganisms with an identical karyotype in
recurrences

T. vaginalis has the ability to

attach to host cells
(cytoadherence) thereby
establishing infection as the
organism overcomes the
constant secretion of the
vagina.

Trichomonads on
vaginal epithelial cells

Two classes of proteins are

Adegbaju et
Cytoadherence and pathogenesis
of Trichomonas
involved
inal.cytoadherence
of T.
Vaginalis. Scientific Research and Essay Vol. 3 (4), pp. 132-138, April 2008
vaginalis, these are the four
adhesion
proteinsofAP65,
AP51,
exact
mechanism
its pathogenesis
has not
AP33clearly
and AP23
and Cysteine
been
elucidated,
many mechanisms are
proteinase.
thought
to be involved. These include (1) cellto-cell adhesion, hemolysis, (2) cell detaching
factors, (3) excretion of soluble factors and (4)
evasion of the host immune system.

Faktor resiko (STI/STD/PMS secara

umum)
Memiliki 1 hal dibawah ini:

Toxoplasma gondii

Toxoplasmosis is an infestation caused by an

obligate intracellular protozoon, Toxoplasma

The classic triad of signs suggestive of congenital

toxoplasmosis includes chorioretinitis, hydrocephalus,
and intracranial calcifications.
However, other clinical manifestations also are
associated with the disease nonspecific

Abnormal spinal fluid

Anemia
Chorioretinitis
Convulsions
Deafness
Fever
Growth retardation
Hepatomegaly
Hydrocephalus
Intracranial

Jaundice
Learning disabilities
Lymphadenopathy
Maculopapular rash
Mental retardation
Microcephaly
Spasticity and palsies
Splenomegaly
Thrombocytopenia
Visual impairment

W. bancrofti Hydrochele

Acquired hydroceles in migratory male

subjects.The typically unshaped,
nontender and transilluminated
hydroceles were considered as acquired to
the W. bancrofti adult worm infection.
The 37 years old subject (TM6A99136;A)
of grade 1 unilateral hydrocele (dart) was
microfilaremic, antigenemic and himself
discovered the hydrocele for 20 years
despite living in the village for 4 years.
The 42 years oldsubject (TM6A99128; B)
of grade 1 unilateral hydrocele with
experience of chyluria was negative of
circulating microfilariae and antigen of W.
bancrofti. The abnormal penis with
nontender nodules (dart) was evident.
The 36 years old subject (TM6A99168; C)
of grade 2 bilateral hydrocele (dart) was
amicrofilaremic, antigenemic and, as long
Bhumiratana et al. SOUTHEAST ASIAN
as he lived in the village, hydrocele was
J TROP MED PUBLIC HEALTH. Vol 33
discovered by himself for 2 years.

 The objective of this series was to show that the

sonographic appearance described as the filarial
dance is not characteristic of filariasis but occurs in
nonendemic areas as a manifestation of epididymal
obstruction.
An experienced observer documented cases after initial
observation of the filarial dance in routine clinical practice
using high-frequency linear array transducers. The filarial
dance was described as excessive to-and-fro
movement of echogenic particles within a prominent
epididymis and graded 1 to 4 according to the extent and
distribution of the abnormality.

J Ultrasound Med 2011; 30:1145

Pthirus pubis
Sucking lice are small wingless external parasites that
feed on blood. Three types of sucking lice infest
humans: the body louse, Pediculus humanus humanus
Linnaeus, also known as Pediculus humanus corporis;
the head louse, Pediculus humanus capitis De Geer;

Diagnosis and
management

Picture Courtesy of National Institute for health

Equivocal = samar-samar

Treatment:
Treatment is not needed for a healthy person who is
not pregnant. Symptoms will usually go away within a few
weeks. Treatment may be recommended for (1) pregnant
women with active infection, (2) persons who have
weakened immune systems, or (3) persons with ocular
disease or (4) severe illness.

The presence of eggs (nits) is the most important indication

of a problem because they are easier to see and inactive,
whereas the lice are near the skin feeding
Delousing methods practiced for many years prior to and during the
early part of World War II were cumbersome and usually expensive.
Methyl bromide, a fumigant which would destroy all stages of the
louse, but which is dangerous to use, was developed in the interval
between
the two World
Wars against head lice can be used also against
Usually treatments
effective
crab lice. The liquid or powder must be applied to the pubic and
anal regions of the body, underarms, and wherever the body is
hairy. In particularly hairy persons, the lousicide should be applied from
neck to foot, perhaps also to eyebrows and beard. The material should
be well distributed and should reach the skin.

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