Trichuris trichiura

Background

Clinical Features

Morbidity is related to number of worms harbored in intestines
Light infections often asymptomatic
Heavier infections with variety of manifestations including GI symptoms (abdominal pain, diarrhea, blood in stool, rectal prolapse), malaise, weakness, impaired cognitive / physical development, malnutrition[1]</ref>
Iron-deficiency anemia
- Adult worms attach to intestinal wall to feed, causing ongoing luminal blood loss

Differential Diagnosis

Helminth infections

Cestodes (Tapeworms)

Trematodes (Flukes)

Nematodes (Roundworms)

Ascaris lumbricoides
Enterobius vermicularis (Pinworm)
Filarial worms
- Loa Loa
- Onchocerciasis
- Lymphatic filariasis (Elephantiasis)
  - Wuchereria bancrofti
  - Brugia malayi
  - Brugia timori
Hookworm
- Necator americanus
- Ancylostoma duodenale
- Cutaneous larva migrans (Ancylostoma braziliense)
Dracunculus medinensis
Strongyloides stercoralis
Trichuris trichiura (Whipworm)
Anisakis
Toxocara spp.
Trichinosis

Workup

Management

Albendazole 400mg x 1 dose
- Historically treated with albendazole or mebendazole, but monotherapy has low efficacy especially in heavy infections; higher cure rate achieved with oxantel pamoate-albendazole combination compared to any monotherapy in recent RCT [2]
Iron supplements in anemia

Disposition

See Also

Worm Infections
Travel Medicine

External Links

References

Wilcox S, Thomas S, Brown D, Nadel E. “Gastrointestinal Parasite.” The Journal of Emergency Medicine, 2007; 33(3):277-280
Speich B, Ame S, et al. "Oxantel Pamoate–Albendazole for Trichuris Trichiura Infection." New England Journal of Medicine, 2014; 370: 610-620.

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