Trichuris trichiura

Needham, C.S., Lillywhite, J.E., Didier, J.M., Bianco, A.E. and Bundy, D.A.P. (1994) Temporal changes in Trichuris trichiura infection and serum isotype responses in children. Parasitology 109,197-200. 

Parasitic helminths, such as Ascaris lumbricoides, Trichuris trichiura, hookworms, schistosomes and filarial nematodes are highly prevalent in tropical and subtropical areas of the world [1]. These infections often overlap and affect more than 1 billion... 

Roundworms (nematodes) pinworm (Enterobius vermicularis) whipworm (Trichuris trichiura) Ascaris lumbricoides Trichinella spiralis Strongyloides stercoralis Hookworm (Necatoramericanus, and Ancylostoma duodenale) mebendazole or pyrantel pamoate mebendazole mebendazole or pyrantel pamoate mebendazole and thiabendazole thiabendazole mebendazole or pyrantel pamoate mebendazole or pyrantel pamoate... 

Trichuris trichiura (whipworm) Mebendazole or albendazole Ivermectin... 

Piperazine is also a drug of choice for treating pinworm infections in children and adults. A dose of 2-2.5 g of piperazine given daily for 14 days gives nearly 100% cures, while a dose of 50-75 mg/kg (maximum 0.5-3g) of piperazine citrate given for 7-14 days produces 85-100% elimination of . vermicularis in man with little or no toxicity [52-54,56,57]. Piperazine and its salts show poor activity against whipworms, Trichuris trichiura in man [63,64]. 

Bundy DA, Cooper E. Nematodes limited to the intestinal tract (Entero-bius vermicularis, Trichuris trichiura and Capillaria philippinensis). In Strickland GT, ed. Himter s Tropical Medicine and Emerging Infectious Diseases, 8th ed. Philadelphia, Saunders, 2000 719—726. 

Whipworm (Trichuris trichiura) adult females are 5 cm long. These worms thread their entire body into the epithelium of the colon, where they feed on tissue juice and small amounts of blood. Infections of several hundred worms may cause irritation and inflammation of the mucosa, with abdominal pain, diarrhea, and gas. Eggs are discharged and passed into the feces. Infections result from the swallowing of eggs that are obtained direcdy from contaminated soil. Untreated adult worms live for years. 

Trichuris trichiura May penetrate gut wall and cause peritonitis Infection by food contaminated with eggs ... 

Thiabendazole s effect on larvae of Trichinella spiralis that have migrated to muscle is questionable. It suppresses egg and larval production and may inhibit the subsequent development of those eggs or larvae that are passed in the feces. Although the exact mechanism is unknown, the drug inhibits the helminth-specific enzyme fumarate reductase. The anthelmintic activity against Trichuris trichiura (whipworm) is least predictable. 

Pyrantel is a depolarizing neuromuscular blocking agent that opens nonselective cation channels and induces marked, persistent activation of nicotinic acetylcholine receptors, which results in spastic paralysis of the worm. Pyrantel is effective against hookworm, pinworm, and roundworm unlike its analog oxantel, it is ineffective against Trichuris trichiura. 

Mebendazole and pyrantel pamoate (not listed in this question) are drugs of choice for the treatment of combined infections due to hookworm and roundworm. If this patient is also infected with Trichuris trichiura (whipworm), mebendazole would be more effective than pyrantel pamoate. The answer is (C). 

Trichuris trichiuria The nematode (roundworm) Trichuris trichiura, also called the human whipworm is the third most common roundworm of humans. Worldwide, with infections more frequent in areas with tropical weather and poor sanitation practices, and among children. It is estimated that 800 million people are infected worldwide. 

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