erratum 23532

modules/m58922/index.cnxml

@@ -17,7 +17,8 @@
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 <para id="fs-id1167663741174">Only one major protozoan species causes infections in the urogenital system. <term id="term-00001">Trichomoniasis</term>, or “trich,” is the most common nonviral STI and is caused by a flagellated protozoan <term class="no-emphasis" id="term-00002"><emphasis effect="italics">Trichomonas vaginalis</emphasis></term>. <emphasis effect="italics">T. vaginalis</emphasis> has an undulating membrane and, generally, an amoeboid shape when attached to cells in the vagina. In culture, it has an oval shape.</para>
-<para id="fs-id1167663640554"><emphasis effect="italics">T. vaginalis</emphasis> is commonly found in the normal <term class="no-emphasis" id="term-00003">microbiota</term> of the vagina. As with other vaginal pathogens, it can cause <term class="no-emphasis" id="term-00004">vaginitis</term> when there is disruption to the normal microbiota. It is found only as a trophozoite and does not form cysts. <emphasis effect="italics">T. vaginalis</emphasis> can adhere to cells using <term class="no-emphasis" id="term-00005">adhesins</term> such as <term class="no-emphasis" id="term-00006">lipoglycans</term>; it also has other cell-surface virulence factors, including <term class="no-emphasis" id="term-00007">tetraspanins</term> that are involved in cell adhesion, motility, and tissue invasion. In addition, <emphasis effect="italics">T. vaginalis</emphasis> is capable of phagocytosing other microbes of the normal microbiota, contributing to the development of an imbalance that is favorable to infection.</para>
+<para id="fs-id1167663640554">It is found only as a trophozoite and does not form cysts. <emphasis effect="italics">T. vaginalis</emphasis> can adhere to cells using adhesins such as lipoglycans; it also has other cell-surface virulence factors, including tetraspanins that are involved in cell adhesion, motility, and tissue invasion. In addition, <emphasis effect="italics">T. vaginalis</emphasis> is capable of phagocytosing other microbes of the normal microbiota, contributing to the development of an imbalance that is favorable to infection.
+</para>
 <para id="fs-id1167663661729">Anyone can develop trichomoniasis. Males are generally asymptomatic, and although females are more likely to develop symptoms, they are often asymptomatic as well. When symptoms do occur, they are characteristic of urethritis. Males experience itching, irritation, discharge from the penis, and burning after urination or ejaculation. Females experience dysuria; itching, burning, redness, and soreness of the genitalia; and vaginal discharge. The infection may also spread to the cervix. Infection increases the risk of transmitting or acquiring HIV and is associated with pregnancy complications such as preterm birth.</para>
 <para id="fs-id1167661646860">Microscopic evaluation of wet mounts is an inexpensive and convenient method of diagnosis, but the sensitivity of this method is low (<link target-id="OSC_Microbio_23_06_TVaginalis"/>). <term class="no-emphasis" id="term-00008">Nucleic acid amplification testing</term> (NAAT) is preferred due to its high sensitivity. Using wet mounts and then NAAT for those who initially test negative is one option to improve sensitivity. Samples may be obtained for NAAT using urine, vaginal, or endocervical specimens for females and with urine and urethral swabs for males. It is also possible to use other methods such as the <term class="no-emphasis" id="term-00009">OSOM <emphasis effect="italics">Trichomonas</emphasis> Rapid Test</term> (an immunochromatographic test that detects antigen) and a DNA probe test for multiple species associated with vaginitis (the <term class="no-emphasis" id="term-00010">Affirm VPII Microbial Identification Test</term> discussed in section 23.5).<footnote id="fs-id1167661429560">Association of Public Health Laboratories. “Advances in Laboratory Detection of <emphasis effect="italics">Trichomonas vaginalis,”</emphasis> 2013.  http://www.aphl.org/AboutAPHL/publications/Documents/ID_2013August_Advances-in-Laboratory-Detection-of-Trichomonas-vaginalis.pdf.</footnote> <emphasis effect="italics">T. vaginalis</emphasis> is sometimes detected on a <term class="no-emphasis" id="term-00011">Pap test</term>, but this is not considered diagnostic due to high rates of false positives and negatives. The recommended treatment for trichomoniasis is oral <term class="no-emphasis" id="term-00012">metronidazole</term> or <term class="no-emphasis" id="term-00013">tinidazole</term>. Sexual partners should be treated as well.</para>
 <figure id="OSC_Microbio_23_06_TVaginalis">