Workup
Laboratory Studies
The following are laboratory studies used in the diagnosis of whipworm infection (trichuriasis):
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Studies often reveal eosinophilia from ongoing tissue invasion (in contrast to all intestinal helminths except Strongyloides stercoralis).
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Rarely, studies show anemia.
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Characteristic eggs on stool smear (oval with transparent bipolar plugs) are visible.
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Each female produces up to 20,000 eggs per day. (No stool concentration technique is necessary.)
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The Kato-Katz technique is a method used to quantify egg numbers.
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Polymerase chain reaction (PCR) using new sequencing techniques are now available in some laboratories to detect the presence of Trichuris with great sensitivity and specificity.
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Imaging Studies
Endoscopy often shows adult worms attached to the bowel mucosa.
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Other Tests
Obtain a stool smear for ova and parasites (as above).
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Procedures
No procedures are indicated in the absence of complications. However, endoscopy may be warranted in instances of severe anemia or refractory infection.
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Media Gallery
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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.
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