History
Most individuals with whipworm infection (trichuriasis) are asymptomatic. Clinical symptoms are limited to patients with heavy infection, who tend to be small children or others with significant exposure. Note that there is no pulmonary migration and, thus, no pulmonary or extra-gastrointestinal symptoms. Symptoms include the following [1, 2] :
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Nocturnal loose stools
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Dysentery can occur in patients with greater than 200 worms.
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Symptoms of anemia (massive infection only)
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Vague abdominal discomfort
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Stunted growth
Physical
Physical findings include the following:
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Mild abdominal tenderness
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Signs of anemia
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Blood on rectal examination or positive guaiac test result
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Finger clubbing can sometimes suggest the diagnosis in infected patients.
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Direct visualization of adult worms on rectal mucosa via endoscopy or if rectum is prolapsed (adult worms only in lower colon in heavy infection)
Causes
Trichuriasis is caused by consumption of soil or food that has been fecally contaminated. (Eggs are infective or embryonated about 2-3 weeks after being deposited in the soil).
Complications
Potential complications of whipworm infection (trichuriasis) include the following:
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Rectal prolapse or anemia
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Vitamin deficiency
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This is an illustration of the life cycle of Trichuris trichiura, the causal agent of trichuriasis. Image courtesy of Centers for Disease Control and Prevention, Alexander J. da Silva, PhD, and Melanie Moser.
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Adult Trichuris trichiura males are 30-45 mm long, with a coiled posterior end. Adult females are 35-50 mm with a straight posterior end. Both sexes have a long, whip-like anterior end. Adults reside in the large intestine, cecum, and appendix of the host. Image shows the posterior end of an adult T trichiura, taken during a colonoscopy. Image courtesy of Duke University Medical Center and Centers for Disease Control and Prevention.
