Whipworm

Question 1

Whipworm - causative organism

Answer 1

Trichuris trichiura
GI nematode

Question 2

Whipworm - adult size

Answer 2

5cm

Question 3

Whipworm - lifecycle

Answer 3

Egg maturation in soil for 3-5 weeks
Ingestion of contaminated soil/food
Eggs hatch in small intestine - microscopic, rugby ball apaearance
Maturation in humans [3 months] - adults sexually differentiate into male and female
Adult worms fixed in caecum and ascending colon with anterior portions threaded into mucosa

Question 4

Whipworm - epidemiology

Answer 4

Anywhere in tropics [as with ascaris - giant roundworm]

Question 5

Whipworm - clinical presentation

Answer 5

-Asymptomatic
-Moderation infections = nausea, abdominal pain, diarrhoea
-Heavy infections = 800+ worms - dysentery, growth stunting secondary to anaemia, rectal prolapse secondary to tenesmus

Question 6

Whipworm - immune response

Answer 6

GI lumen but heads buried in mucosa - antigen presentation to GALT
Eosinophilic response mild

Question 7

Whipworm - diagnosis

Answer 7

Clinical suspicion
Eggs in stool OCP
Adults visible on colonoscopy

Question 8

Whipworm - treatment

Answer 8

Albendazole [more effective than mebendazole]