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Trichuris trichiura

Microbiology > Parasitology > Nematodes
Trichuris trichiura (Whipworm)
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Structure:  Helminth, nematode (roundworm), commonly referred to as whipworm as it resembles the handle and lash of a whip.

• Infections occur worldwide in warm, humid climates or during the summer months in temperate climates, where sanitation and hygiene are poor.
• Along with pinworm, one of the most common nematode infections worldwide.
• Transmission is fecal-oral, where soil contaminated with infective eggs is ingested via hands and/or improperly prepared food.

• Ingested eggs hatch in the small intestine and release larvae which migrate to the colon where they penetrate the mucosa and mature into adults.
• The fertilized adult female worm lays numerous eggs which pass into the stool.
• Eggs passed into the soil mature and become infectious (embryonated eggs) in approximately 2-3 weeks.  

Disease Manifestations:
• Most infections are asymptomatic.
• In moderate to heavy infections, stools may be loose and contain mucous and/or blood.
• Rectal prolapse or secondary anemia may be observed in patients with heavy worm burdens.

Laboratory Diagnosis:
• Stool exam for eggs.  The eggs are 50 x 24 microns with a characteristic barrel shape and a thick hyaline plug at each end.
• Colonoscopy: adult worms protruding from the intestinal mucosa (the thick end is visible in the bowel lumen)

Differential Diagnosis:

• Mebendazole for 3 days or albendazole for 3 days
Prevention & Control:
• Proper sanitation and food preparation.  Avoid ingesting soil contaminated by Trichuris eggs.

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