TRICHURIS TRICHIURA

• TRICHURIS TRICHIURA

  • Synonyms: Trichocephalus trichiurus and Trichocephalus dispar
  • Common name: whipworm
  • Infective stage: embryonated ova
  • Principal host: man, but has been found in hogs, monkeys, cattle, dogs, mice

  1. Embryonic development would usually take place outside the host
  2. An unhatched, infective, first stage larva is produced in 3 weeks in a favorable environment like warm moist or shaded soil.

  • Main habitat: cecum & appendix
  • Life span: 5-10 years
• DIAGNOSIS

  • Direct Fecal Smear
  • Kato Thick Smear
  • Concentration methods
• Ova characteristics:

  • Barrel/football-shaped, Japanese lantern
  • Brown: lemon-shaped with pluglike translucent polar prominences
  • Yellowish outer and transparent inner shell
  • 50 µm x 25µm in size
  • 3 layers: undeveloped, unicellular embryo; outermost layer smooth, bile-stained; hyaline/mucus plug seen in both ends of the ova
• Fertilized eggs:

  • Unsegmented
  • Less resistant to desiccation, heat, and cold compared to Ascaris lumbricoides eggs
• Adult characteristics:

  • Flesh-colored
  • Anterior three-fifths are attenuated (whiplike)
  • Stichosoma type of esophagus
• Male characteristics:

  • 30-45 mm in size
  • Posterior portion coiled (>/=360°)
  • Lanceolate spicule protruding through a refractile pineal sheath
  • Inverted spiculate at the posterior portion of the male
• Female characteristics:

  • 35-50 mm in size
  • Bluntly rounded posterior end
  • 3,000-10,000 eggs produced per day
• Trichuriasis symptoms include:

  • Blood or mucoid diarrhea
  • Weight loss and weakness
  • Abdominal pain tenderness
  • Increased peristalsis and rectal prolapse
  • Nausea, vomiting, anemia, fatigue, weakness, and general body wasting
  • Obstruction and inflammation of the appendix (appendicitis)
  • Hypoalbuminemia and IDA
  • Extreme cachexia (weakness and wasting due to severe chronic illness)
  • Wasting syndrome (loss of weight, muscle atrophy, fatigue, weakness, and significant loss of appetite)
• TREATMENT

  • Mebendazole (500mg)
  • Albendazole (400mg)
• PREVENTION

  • Sanitary disposal of feces
  • Thorough washing of hands
  • Thorough washing and cooking of food
  • Avoid using human feces as fertilizer