Whipworm infection

Elecampane is stated to possess expectorant, antitussive, diaphoretic, and bactericidal properties. Traditionally, it is used in the treatment of bronchial and tracheal catarrh, cough associated with pulmonary tuberculosis, and dry irritating cough in children. Alantolactone is used as an anthelmintic in the treatment of roundworm, threadworm, and whipworm infection. 

Thiabendazole has broad-.spectmm anthelmintic activity. It is used to (real enterobiasis, strongyloidiasis (threadworm infection), a.scariasis, uncinariasis (hookworm infection), and trichuriasis (whipworm infection). It has also been u.sed to relieve symptoms associated with cutaneous larva migrans (creeping eruption) and the inva.sive phase of trichinosis. In addition to its use in human medicine, thiabendazole is widely used in veterinary practice to control intestinal helminths in iive.stock. 

Whipworm infection Tridiuris trichiura Dichlorovos, thiabendazole mebendazole, oxantel... 

Clinical use Mebendazole is a drag of choice for pinworm and whipworm infections. It is one of two drugs of choice (with pyrantel pamoate) for roundworm and for combined infections with ascarids and hookworm. Mebendazole can also be used as a backup drag in certain cestode and trematode infections. Less than 10% of the drag is absorbed systemi-cally after oral use, and this portion is metabolized rapidly. 

Anthelmintic important drug for pinworm and whipworm infections. Inhibits microtubule synthesis and glucose uptake in nematodes. Tox GI distress, caution in pregnancy. Albendazole and thiabendazole are related anthelmintics. 

E) Rnworm and whipworm infections respond well to mebendazole... 

Whipworm (Trichuris trichiurd) 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 directly from contaminated soil. Untreated adult worms Hve for years. 

Although more people are being fed than ever before, there are also more malnourished humans than ever before. Thus, more than 1.6 billion of the 5.3 billion people living today are malnourished and do not have access to adequate supplies of food (3), Clearly, a malnourished person cannot lead a fully productive life. The plight of these people is more serious than just a lack of adequate food, for many are ill with disease and/or carry heavy loads of parasites. For example, a survey of school children in Kwale District, Kenya showed that 96% were infected with hookworms, 50% with roundworms, 95% with whipworms, and 40% with schistosomiasis... 

Mebendazole is a benzimidazole carbamate derivative that is used for the treatment of threadworm, roundworm, whipworm and hookworm infections. It is not recommended for women who are pregnant and in children under 2 years because the manufacturer reports that toxicity in animal studies has been reported. 

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. 

This is a relatively new enteric helminth disease of human caused by a minute whipworm, CapiUaria philippinensis, which was responsible for severe enteritis with high mortality in the Province of Ilocos Norte on the north west coast of Luzon of Philippines in 1967. Later the infection was reported from other adjacent provinces and from southern Thailand [27]. 

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]. 

Oxantel may also be used to treat ascariasis, enterobiasis, hookworm infections and trichuriasis if given in combination with pyrantel pamoate or levamisole [18,23]. Thus, a combination of pyrantel pamoate (5 mg/kg) and oxantel pamoate (5 mg/kg) given on two consecutive days produced 94% reduction in egg output in a large number of Chinese patients infected with Ascaris, whipworms and hookworms [34]. Like pyrantel pamoate, oxantel is also well tolerated producing only mild and transient side effects [18]. 

The fact that most intestinal nematodes elicit a Th2 response in chronic infection has suggested the possibility to use experimental infections with such parasites for the treatment of Thl-mediated diseases, such as the inflammatory bowel diseases. Patients affected with Crohn s disease or ulcerative cohtis were treated with the ova of a porcine whipworm Trichuris suis, which resulted in clinical amehoration of both diseases. 

Mebendazole (MB) is somewhat broader in its anthelmintic spectrum. In addition to the two hookworms and Ascaris, the drug also eliminates pinworms, whipworms, and possibly threadworms. This spectrum and essentially no toxicity makes it a particularly valuable drug in mixed infections. MB is even effective against the intestinal trichinosis organism, but it may not be in the muscle form. 

Pyrantel, as pyrvinium, is available as the extremely insoluble and nonabsorbed pamoic acid salt one oral dose cures pinworm and Ascaris infections. It is curious that whipworm and threadworm infections do not respond. The drug acts as a depolarizing neuromuscular blocking agent (Chapter 8) on worms, which are then paralyzed. In Ascaris muscle strips it is 100 times more active than acetylcholine. 

Mebendazole is a benzimidazole that kills parasitic worms by blocking glucose uptake, thus depleting stored glycogen. Without glycogen, parasites cannot reproduce or survive. It is indicated in the treatment of Trichuris trichuria (whipworm), Enterobius vermicularis (pinworm), Ascaris lum-bricoides (roundworm), Ancylostoma duodenale (common hookworm), or Necator americanus (American hookworm), in single infection or mixed infections. 

Some members of the orthosomycins, a group of compounds known for their antibiotic activity, showed activity against intestinal nematodes [429], The nucleoside peptide aspiculamycin (250), isolated from Strepto-myces toyocaensis, at 50 mg/kg, completely eliminated Aspicularis tetra-ptera and Syphacia obvelata (pinworm) from the intestinal tract of infected mice [430]. The related compound (251) has been claimed to show nematocidal activity towards B. lignicolus [431]. Anthelmycin (252) (hikizimycin) has been found to be effective against pinworms, round-worms and whipworms [432]. 

The medically important intestinal nematodes responsive to drug therapy include Enterobius vermic-ularis (pinworm), Trichuris trichiuria (whipworm), Ascaris lumbricoides (roundworm), ancy-clostoma and necator species (hookworms), and Strongyloides stercoralis (threadworm). Over one billion persons worldwide are estimated to be infected by intestinal nematodes. Pinworm infections... 

Clinical use Albendazole has a wide anthelmintic spectrum. It is an alternative drug for larva migrans, for ascariasis, and for infections caused by roundworms, whipworms, hookworms, pinworms, and threadworms. Albendazole is also active against the pork tapeworm in the larval stage. 

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. 

Whipworms. Triefturis trwhiauria causes infection of the gut lumen, often together with Ascaris and hookworms. Light a.symptomatic infection is common. Mebendazole is effective. 

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. 

Orally al orbed anthelmintic used for treatment of infections caused by pinwonn, whipworm, common roundworm, and hodtworms. 

Neglected tropical diseases affect a substantial proportion of the world population. Estimates show that around 1.2 billion people are infected with Ascaris lum-bricoides (roundworm) 795 million with Trichuris trichi-ura (whipworm) 740 million with Necator americanus and Ancylostoma duodenale (hookworm) 200 million with Schistosoma mansoni, S. haematobium, or S. japonicum (bilharzia) 120 million with lymphatic filariasis (elephantiasis) and 25 million with Onchocerca volvulus (river blindness or onchocerciasis). 

Nematode Infections - Nematode parasites cause medically and economically important diseases in man and his domestic animals throu out the world. Among the more than 25 different worms that affect man, the large roundworm, the hookworm and the whipworm are responsible for more than half of mankind s helminthiases. The n imber of hiiman helminthic Infections in the United States has been estimated at about 44 million. The majority of these infections is due to pinworms (enterobiasis). 

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