An intestinal helminth infection caused by the nematode Trichuris trichiura
Aetiology
Causative Organisms
Trichuris trichiura
Morphology
Feature | Description |
Adult worm shape | Whip-like (thin anterior, thick posterior) |
Length | 3–5 cm |
Habitat | Cecum and colon |
Anterior portion | Embedded in mucosa |
Egg morphology:
Feature | Description |
Shape | Barrel-shaped |
Shell | Thick |
Polar plugs | Present at both ends |
Pathophysiology
The infection occurs via the fecal–oral route.
Life Cycle Stages
- Eggs are passed in human feces
- Eggs mature in soil (become infective)
- Humans ingest embryonated eggs
- Larvae hatch in the small intestine
- Larvae migrate to the cecum and colon
- Mature worms embed in intestinal mucosa
Adult worms live for 1–3 years.
Pathogenesis
The anterior end of the worm penetrates the colonic mucosa, causing:
- Mucosal inflammation
- Microbleeding
- Colitis
Heavy infection can lead to:
- Chronic diarrhea
- Protein loss
- Iron deficiency anemia
Clinical Presentation
Mild Infection
Often asymptomatic.
Possible symptoms:
- Mild abdominal discomfort
- Intermittent diarrhea
- Anorexia
Moderate Infection
Symptom | Mechanism |
Chronic diarrhea | Colonic irritation |
Abdominal pain | Inflammation |
Mucus in stool | Colitis |
Weight loss | Nutritional deficiency |
Severe Infection (Trichuris Dysentery Syndrome)
Occurs mainly in children with heavy infestation.
Features:
- Chronic bloody diarrhea
- Severe anemia
- Growth retardation
- Protein-energy malnutrition
- Tenesmus
Classic complication:
Rectal prolapse
Investigations
Stool Examination (Diagnostic Test)
Management
First-Line Anthelmintic Drugs
Drug | Dose |
Albendazole | 400 mg 1x1 for 3 days |
Mebendazole | 500 mg SD |
Mebendazole | 100 mg 2x1 for 3 days |
Alternative treatment:
Ivermectin 200 µg/kg daily for 3 days
Note: Trichuris is less responsive to single-dose therapy, therefore multi-day regimens are preferred.
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