Giemsa-stained smears of empyema fluid. (A) Trichomonads showing piriform and ellipsoidal shapes. (B) Amoeboid forms with some pseudopods. Internal structures such as the axostyle-pelta complex and flagella are not clearly visible; only food vacuoles are evident. In both cases, several bacteria are present. Bars, 14 μm. (C) Ethidium bromide-stained agarose gel showing PCR amplicons of the ITS1-5.8S-rRNA-ITS2 gene of Trichomonadinae. Lanes: 1, 100-bp DNA molecular size marker; 2 and 3, total DNA obtained from empyema fluid samples from cases 1 and 2, respectively; 4, DNA from an oral sample from case 2; 5, DNA from a vaginal specimen with T. vaginalis as a positive control; 6, negative control.