Trichuris trichiura infection

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. 

Benjamin Speich B, Ame SM, Ali SM, Alles R, Hattendorf J, Utzinger J, et al. Efficacy and safety of nitazoxanide, albendazole, andnitazoxanide-albendazole against Trichuris trichiura infection a randomized controlled trial. PLOS 2012 6(6) el685. 

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... 

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]. 

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 ... 

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. 

Knopp S, Mohammed KA, Speich B, Hattendorf J, Khamis IS, Khamis AN, Stothard JR, Rollinson D, Marti H, Utzinger J. Albendazole and mebendazole administered alone or in combination with ivermectin against Trichuris trichiura a randomized controlled trial. Clin Infect Dis 2010 51 1420-8. 

There is little evidence for a role of IgE in host protection against chronic infections with other geohelminth parasites such as Trichuris trichiura (77) and Ascaris lumbricoides (78,79). Of interest, the Trichuris dysentery syndrome, observed occasionally in children with heavy infections, demonstrated marked mucosal mastocytosis and infiltration by IgE-staining cells but with little impact on intestinal parasite burden (80). There is some epidemiological evidence that IgE may be protective in human hookworm infections (81,82), but, as with schistosomiasis, there are significant problems in the interpretation of these correlational field data. 

The disease is caused by Trichuris (Trichocephahis) trichiura, commonly known as whipworms, which live embedded in the intestine especially in the large bowel and caecum of man. The infection is cosmopolitan and is found more in children than adults. The usual mode of infection is the consumption of water and vegetables contaminated with the ova of T. trichiura. The disease is usually asymptomatic in the case of light infection however, heavy infections may lead to anaemia, eosinophilia, abdominal pain, diarrhea, mucoid stool and occassional prolapse of the rectum. 

Most of the therapeutic helminth trials to date have used Trichuris suit, the porcine whipworm (Fig. 2). T. suit is closely related to T. trichiura (human whipworm) and can briefly colonize people. Trichuris spp. have unique features that make them good candidates for clinical use. Ingesting microscopic embryonated parasite eggs initiates the colonization. Once ingested each e releases one larva that matures into an adult worm. The larvae and adults do not migrate beyond the intestines. They do not multiply within their host. Freshly deposited ova require incubation in moist soil for one to two months to mature and become infective. Thus, normal hygienic practices preclude transmission of this agent from host to host. 

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