Trichuris Truchuria ( Whip Worm )

Question 1

Epidemiology of whipworm infection

Answer 1

Worldwide distribution like Ascaris lumbricoides
Prevalence directly correlated with poor sanitation and use of human faeces as fertilizer
No animal reservoir is recognized

Question 2

What nematode is associated with rectal prolapse.

Explain

Answer 2

Trichuris Truchuria may cause rectal prolapse in children with heavy infection. Prolapse results from increased persitalsis that occurs in an effort to expel the worms

Question 3

Rectal prolapse and Trichuris

Answer 3

The whitish worms are seen on prolapsed mucosa
Has eggs with bipolar plugs

Question 4

Describe the egg morphology of Truchuria trichuris

Answer 4

Barrel shaped,
2 polar plugs
Unsegmented embryo

Question 5

Describe the morphology of adult whipworm

Answer 5

Trichuris - hair like tail
The name is not quite accurate as it is the anterior end that is hair like not the tail end.
Whipworm- thick post part resembles the stock and thin anterior lash of a whip

Question 6

Life cycle (7steps)

Answer 6

1. Unembryonated eggs passed in faeces
2. 2 cell stage
3. Advanced cleavage
4. Embryonated eggs are ingested
5. Ingested eggs hatch in small intestine into larval worms
6. Migrate to the caecum
7. Penetrate the mucosa and mature to adults.

Question 7

How long can female Trichuris live ?

Answer 7

Can live UpTo 8 years

Question 8

How many eggs do the female Trichuris release per day ?

Answer 8

3000-10000

Question 9

Eggs passed into soil become infectious after ___weeks

Answer 9

3wks

Question 10

Clinical features - related to intensity of worm burden (7)

Answer 10

Mostly small in number, asymptomatic
Many larvae > abdominal pain and distention, bloody diarrhoea, weakness and weight loss
Appendicitis as worms fill the lumen
Rectal prolapse in children
Anaemia and eosinophilia in severe infection

Question 11

Secondary bacterial infection with Trichuris

Answer 11

Allows worm head to penetrate deep into the intestinal mucosa

Question 12

Lab diagnosis

Answer 12

Stool: characteristic with dark bile staining , a barrel shape, and presence of polar plugs in the egg shell

Question 13

Mode of transmission

Answer 13

Humans are infected by ingesting worm eggs in food or water contaminated with human faeces

Question 14

Treatment

Answer 14

Albendazole

Question 15

Prevention

Answer 15

Proper disposal of faeces , prevents transmission

Question 16

T/F: there is animal reservoirs in Trichuris

Answer 16

False