British Medical Journal

To the Editor


August 17th 1989






Sir, - I read with great interest the paper about sarcoid artropathy in cystic fibrosis (CF) (1). It proves once more that in the CF picture there can appear various pathological manifestations. During my research of trichomoniasisi and CF (2), there appeared a problem of possible relation between trichomonemia and other pathological entities as well as rheumatism (3). That relation can be explained by the immune disorder that can be due to chronic or recurrent trichomoniasis.


Like arthritis of the knee joint as complication of genital gonorrhea, it seems to me logical to presume possible relation between trichomoniasis (urotract?) and the state of knee joints in presented case.


Out of three human trichomonal species – T. vaginalis (urogenitalis), T. intestinalis and T. tenax (oralis) – only the first one is known to be pathogenic.


If gonococcus can through the lymph ways, come from genital s into the knee joint and cause artropathy, a possibility can not be apriori rejected, that trichomonads as well, or their antigens only, could penetrate in the same way, from  urotract of the CF patient described. Histopathological picture of synovia of the case presented, is strikingly similar to hyperplasia of connective tissue in chronic trichomonal cervicitis uteri, as well as in the experimentally infected animals (4).


Therefore, I think that in the presented and similar cases there should be excluded trichomonal infestation of the nearest excretory organ disregarding which relation between trichomonads and CF it is about.


S. Krvavac


Women’s Health Institute

University and Medical Centre

Alajbegovica 1, 71000 Sarajevo, Yugoslavia



  1. Sodem M. Tempany E. Bresnihan B. Sarcoid arthropathy in cystic fibrosis. BR J Rheumatol 1989;28:341-343.
  2. Krvavac Š. Aflagellary forms of Trichomonas species as etiologic agent of cystic fibrosis. XIIth World Gyn/Obst Congress, Rio de Janeiro 1988, Abstracts, pp.681-682.   
  3. Krvavac Š. Possible correlation between high erythrocyte sedimentation rate and trichichomonaemia in rheumatic diseases. I: Abstracts of the 3rd Interscience world Conference on Inflammation, Monte Carlo, 1989: p. 274.
  4. Honigberg B. M. Trichomonads of importance in human medicine. In Kreier J. P. ed.: Parasitic Protozoa, Vol. 2.  Academic Press Inc New York, 1978. pp. 275-454.