Trichuris Trichiura Flashcards by Kyra Catedral

Common Name:

Whipworm

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STH?

Yes

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EPIDEMIOLOGY

_________distribution
Common in ______ regions (warm, moist environment), poor sanitation

Present in temperate zone

______million infected worldwide

_____years old: most commonly affected

Worldwide

tropical

604-795

5-15

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somatic muscle arrangement of TT

Holomyarian

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Habitat of TT

colon, cecum

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Color of TT

Flesh or pinkish slender nematode

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T. Trichiura

Anterior end:
Attenuated anterior three-fifths traversed by a narrow esophagus resembling a string of beads

Secrete a pore-forming protein called_____ → embed into the intestinal wall

TT47

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T. Trichiura

Posterior end
Robust two-fifths containing intestine and single set of reproductive organs

Male: coiled with____ spicule and retractile sheath

Female: blunt
Lays __________eggs/day

single

3,000-10,000

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shaped like?

with plug-like translucent hyaline and refractile polar prominences

Lemon- or barrel- or football

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T. Trichiura

Embryonic development in the environment (____weeks)

2-3

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T trichiura

LAYERS OF SHELL
outermost layer, smooth, yellow-brown color
middle
innermost, transparent

Bile-stained layer
Albuminous layer
Chorionic layer

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What nematode?

Soon after embryonated eggs are ingested, larvae escape and penetrate the intestinal villi where they remain for 3-10 days

Trichuris trichiura

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Trichuris trichiura

4 larval stages:
Heart-lung migration?
Diagnostic stage:
Infective stage:

12 weeks
No heart-lung migration
Unembryonated egg & adult worms
Embryonated egg

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T trichiura

PARTHENOGENESIS & CLINICAL MANIFESTATIONS

Intestinal petechial hemorrhages
Intestinal bleeding is common
Acute appendicitis
Rectal prolapse in heavy chronic trichuriasis

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Anterior portions embedded in the mucosa

Predispose to amoebic dysentery

Intestinal petechial hemorrhages

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Lumen of appendix is filled with worms

Acute appendicitis

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Blood-streaked diarrheal stools
Abdominal pain
Weight loss
Blood loss: 0.8-8.6mL/day → anemia

Rectal prolapse in heavy chronic trichuriasis

LABORATORY DIAGNOSIS

Demonstration of unembryonated ova

Direct fecal smear with a drop of saline

Kato-Katz technique

Acid-Ether and Formalin-Ether/Ethyl

Acetate Concentration technique

FLOTAC technique

more sensitive than
Kato-Katz and ether/ethyl acetate concentration technique

FLOTAC technique

T trichiura

Drug of choice

Alternative

Mebendazole 100mg BID × 3 days
Mebendazole 500mg OD x 3 days

Albendazole 400mg OD × 3 days

WASHED Framework for the control of STH

Provision of safe water
Environmental sanitation
Hygiene education
Regular deworming

Mass Drug Administration among school-aged children
______among STH prevalence ≥50%
______among STH prevalence <50%

Drug:

Biannual

Once a year

Mebendazole 500mg one dose
Albendazole 400mg one dose

Disease TT

Trichiuriasis

● Soil-transmitted helminth (STH)
●______ Decorticated (smooth)
● Millimeters in length– does not cause intestinal obstruction
● RESIDENCE –______

Holomyarian

large intestine

Heart lung migration? TT

None

Male TT - Ventrally____ posterior end - contains___ copulatory spicule - Measures 3 - 3.5 cm - A single lanceolate spicule protrudes through a refractile penial sheath which has a bulbous termination covered with small recurved spines - Distinguished from the female by its coiled caudal extremity about_____ degrees or more

curved one 360 degrees

FEMALE TY - Lifespan:____ years - Measures 3.5 - 5.5 cm in length - Vulva opens at the anterior end, the fleshy portion of the body - Has a single uterus and ovary - Bluntly____ at the posterior end

2 rounded

Phasmid/ Aphasmid?

Aphasmid

TT Definitive = Intermediate =

Humans None

MOT TT

Ingestion of embryonated egg

Source of infection TT

Fecal-oral transmission

Infective stage TT

Embryonated egg

Diagnostic stage

Unembryonated egg (unsegmented)

Pathogenesis & Clinical Manifestations TT

● Intestinal petechial hemorrhages ○ Anterior portions embedded in the mucosa ○ Predispose to amoebic dysentery ● Intestinal bleeding is common ● Acute appendicitis ○ Lumen of appendix is filled with worms ● Rectal prolapse in heavy chronic trichuriasis ○ Blood-streaked diarrheal stools ○ Abdominal pain ○ Weight loss ○ Blood loss: 0.8-8.6mL/day → anemia

Diagnosis

1) Direct Fecal Smear (DFS) 2) Kato-Katz Technique 3) Concentration Technique (Recovery of eggs in the stool specimen)

Adult morphology: TT _____colored or_______worm _______of the worm is attenuated and thin in contrast to the remaining______ is fleshy and robust "_____like appearance"

Flesh/ pinkish slender Anterior 2/3; posterior 1/3 which Whip

Ova Morphology • characteristically_______-shaped with bipolar unstained intralaminar prominences which have the appearance of_____ plugs • measures 50-54 micra by 22-23 micra

barrel; mucoid

TT Ova in addition to a vitelline membrane, it has a triple shell consisting of:

• chorionic layer • albuminous layer • bile-stained layer

Trichuris trichiura Life Cycle -Infective Stage -Definitive Host -Diagnostic Stage

embryonated egg Humans egg (unsegmented)

TT Habitat

Large intestine

Trichuris trichiura • Pathology:

1. Mild ulceration 2. Abdominal pain 3. Diarrhea 4. “rectal prolapse”