Trichuris trichiura

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Background

Clinical Features

  • Morbidity is related to number of worms harbored in intestines
  • Light infections often asymptomatic
  • Heavier infections with variety of manifestations including GI symptoms (abdominal pain, diarrhea, blood in stool, rectal prolapse), malaise, weakness, impaired cognitive / physical development, malnutrition[1]</ref>
  • Iron-deficiency anemia
    • Adult worms attach to intestinal wall to feed, causing ongoing luminal blood loss

Differential Diagnosis

Workup

Management

  • Albendazole 400 mg x 1 dose
    • Historically treated with albendazole or mebendazole, but monotherapy has low efficacy especially in heavy infections; higher cure rate achieved with oxantel pamoate-albendazole combination compared to any monotherapy in recent RCT [2]
  • Iron supplements in anemia

Disposition

See Also

External Links

Sources

  1. Wilcox S, Thomas S, Brown D, Nadel E. “Gastrointestinal Parasite.” The Journal of Emergency Medicine, 2007; 33(3):277-280
  2. Speich B, Ame S, et al. "Oxantel Pamoate–Albendazole for Trichuris Trichiura Infection." New England Journal of Medicine, 2014; 370: 610-620.