subject: Trichuriasis clinical features and management [print this page] Trichuriasis clinical features and management
Trichuriasis is infection of the intestinal lumen with thenematode Trichuris trichiura. Most patients are asymptomatic.Malnutrition is associated with heavy infections,causing symptomatic disease which can include stunting ofgrowth and rectal bleeding. Eggs are swallowed and thelarvae hatch. They mature during their transit down thesmall intestine, and adults are found in the terminal ileumand colon. The eggs mature in soil and are ingested. Theadult worm has a long thin anterior end and a short thickposterior end. This appearance is described by the commonname of the parasite, the whipworm. The thick posteriorend grips the colonic mucosa.
Clinical featuresMost people are asymptomatic and eggs are found onfaecal microscopy. Malnourished children may becomeinfected with large numbers of these worms, and diarrhoeawith blood in the stool may result. These children oftenhave stunted growth. On proctoscopy large numbers ofworms can be seen adhering to the rectal mucosa. Rectalprolapse is sometimes seen in these malnourished children.It is difficult to know if the worm burden is the cause orthe result of malnutrition.
Diagnosis and management Diagnosis is made by finding eggs in faecal smears or concentrates.Mebendazole (100mg twice daily for 3 days) iseffective. A marked catch-up in growth occurs in stunted children after their infection is cleared.
Most patients are asymptomatic.Malnutrition is associated with heavy infections,causing symptomatic disease which can include stunting ofgrowth and rectal bleeding. Eggs are swallowed and thelarvae hatch. They mature during their transit down thesmall intestine, and adults are found in the terminal ileumand colon. prevention is done by eatinng fresh food and drinkingboiled purifiedwater
