Trichuris Trichiura (Whipworm) Infection (Trichuriasis) Clinical Presentation

Updated: Apr 15, 2016
  • Author: Kwame Donkor, MD; Chief Editor: Jeter (Jay) Pritchard Taylor, III, MD  more...
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Presentation

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.

  • Nocturnal loose stools
  • Dysentery can occur in patients with greater than 200 worms.
  • Rectal prolapse
  • Failure to thrive
  • Symptoms of anemia (massive infection only)
  • Vague abdominal discomfort
  • Stunted growth
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Physical

See the list below:

  • Mild abdominal tenderness
  • Signs of anemia
  • Rectal prolapse
  • Finger clubbing can sometimes suggest the diagnosis in infected patients.
  • Direct visualization of adult worms on rectal mucosa via endoscopy or if rectum is prolapsed (adult worms only in lower colon in heavy infection)
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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).

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