Trichuriasis

Alternative names
Whipworm infection

Definition
A parasitic infection of the large intestine caused by whipworm (Trichocephalus trichiura).

Causes, incidence, and risk factors

Whipworm infection is a common worldwide infection which primarily affects children, who may become infected if they ingest soil contaminated with whipworm eggs. The ingested eggs hatch, and the whipworm embeds in the wall of the large intestine (cecum, colon, rectum).

Whipworm is found throughout the world, in particular among countries with warm, humid climates. The main risk factor for infection is ingestion of eggs from soil contaminated with feces. Some outbreaks have been traced to contaminated vegetables (due to presumed soil contamination).

The development of symptoms depends on the burden of worms/eggs. Light infestations may lead to few or no symptoms. Heavy infestations may result in bloody diarrhea, iron-deficiency anemia and on occasion, rectal prolapse.

Symptoms

     
  • Light infestations are frequently asymptomatic (have no symptoms).  
  • Heavy infestations may have bloody diarrhea.  
  • Long-standing blood loss may lead to iron-deficiency anemia.  
  • Rectal prolapse is seen in severe cases.

Signs and tests

A stool ova and parasites exam reveals the presence of whipworm eggs.

Treatment
Oral treatment with mebendazole for 3 days is commonly used in symptomatic infections. Another anti-parasitic agent (albendazole) can be used as an alternative therapy.

Expectations (prognosis)
Full recovery is expected with treatment.

Complications

In severe cases, dehydration and anemia from bloody diarrhea can occur. Rarely, rectal prolapse can also occur.

Calling your health care provider
Seek medical attention if you or your child develop bloody diarrhea. In addition to whipworm, there are many other infections and illnesses that may show themselves in similar manner and require further investigation.

Prevention
Improved facilities for feces disposal have decreased the incidence of whipworm. Handwashing before food handling, and avoiding ingestion of soil by thorough washing of food that may have been contaminated with egg-containing soil are other preventive measures.

Johns Hopkins patient information

Last revised: December 4, 2012
by Janet G. Derge, M.D.

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