Argyll Robertson pupils due to neurosarcoidosis: evidence for site of lesion.

well to treatment with metronidazole. We were able, however, to make an immediate diagnosis of infection with Trichomonas vaginalis by microscopical examination of wet preparations ofthe tracheal aspirate and gastric contents. We cannot be certain that our patient's disease was caused by this organism. Aspiration of amniotic fluid results in a similar picture, and the organism may have been just a contaminant. Bacterial pneumonia was also a possibility, despite the negative cultures, as the patient improved with antibacterial treatment without receiving specific treatment for Trichomonas vaginalis. Nevertheless, the findings in our patient, including his slow recovery, and the report of McLaren et al suggest that Trichomonas vaginalis may be an unrecognised cause of neonatal pneumonia. Determining the cause of respiratory distress in an ill baby is often difficult, and infection with Trichomonas vaginalis should be considered when the aetiology is not clear. In these circumstances direct microscopical examination ofwet preparations of gastric content and tracheal aspirate is a useful screening test. Further work is needed on the incidence of contamination of the newborn with this organism, which commonly infects mothers during pregnancy,3 and consequent respiratory infection.