Helminth

Whipworm

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Whipworm, Trichuris trichiura

  • See Also
  1. Helminth
  2. Parasitic Infection
  • Epidemiology
  1. One of the most prevalent human Helminth infections
  2. Most symptomatic infections occur in school aged children
  • Pathophysiology
  1. Cylindrical or bullwhip-shaped worm, adult length: 3 to 5 mm
  2. Transmission
    1. Human feces contaminated fruits and vegetables
  3. Slow, simple Life cycle
    1. Whipworm eggs incubate in moist soil for 3-6 weeks
    2. Humans ingest food contaminated with Whipworm eggs (Foodborne Illness)
    3. Larvae emerge from eggs in the ascending colon (esp. cecum) and mature into adults
      1. Whipworms are limited to the host's intestinal tract (no systemic infection or Eosinophilia)
    4. Adult Whipworm produces eggs, which are passed in feces, and contaminate soil
      1. Adult worms may produce thousands of eggs each day for >1 year
      2. No autoinfection or direct transmission between hosts (eggs mature in soil for 3-6 weeks)
  • Symptoms
  1. Usually asymptomatic
  2. Diarrhea
  3. Colitis
  4. Abdominal Pain (may be similar to Appendicitis pain)
    1. Right Lower Quadrant Abdominal Pain
    2. Periumbilical Abdominal Pain
  • Labs
  1. Eosinophilia is ABSENT (infection is limited to the host's intestinal tract)
  2. Stool Exam
    1. Barrel or football shaped eggs with small nubs on each end
  • Management
  1. Mebendazole (Vermox, Emverm)
  2. Albendazole
  • Complications
  • Untreated Infection (endemic regions)
  1. Digital Clubbing
  2. Growth retardation
  3. Rectal Prolapse
  • References
  1. Gladwin, Trattler and Mahan (2014) Clinical Microbiology, Medmaster, Fl, p. 362-81
  2. Schonau (2024) Am Fam Physician 109(6): 569-70 [PubMed]