This document summarizes information about the whipworm (Trichuris trichura) including its morphology, life cycle, pathogenesis, clinical features, diagnosis, treatment and prevention. It notes that the adult worm is 50mm long with a thicker posterior end. Eggs measure 50-54 by 22-23 micrometers and contain unembryonated eggs that are passed in stool. The life cycle involves ingestion of eggs which hatch and develop into adults in the intestines. Clinical features range from asymptomatic to digestive disturbances depending on worm burden. Diagnosis involves examining stool for eggs using iodine or histopathology of intestinal mucosa. Treatment involves albendazole or mebendazole.

1. PRESENTED BY:
Man Bdr. Rana
BPH 1st sem 2074
ACAS,Nepal

2. Morphology of Adult worms :
 50 mm long with a slender anterior and a thicker
posterior end .
 Male is smaller and has a coiled posterior end

3. Morphology of eggs :
 Eggs in stool.
 Size 50-54 micro meter by 22-23 micro meter .
 Shape is a typical barrel.
 Color is yellow brown (unstained two polar plugs).
 Shell quite thick.
 Contains unembryonated eggs .

4. LIFE CYCLE :

5. LIFE CYCLE :

6. PATHOGENESIS :
 Humans sole host.
 Transmission :
fecal-oral via embryonated ova
• Frequently coexists with ascaris
• Reservoir :
Mainly human , other possible but host specificity not well documented.
• Pathogenic potential:
Low to moderate,dependent on worm numbers and location in large
intestine
• Entirely intraluminal life cycle – eggs are ingested.

7.  Eggs hatch in intestines , larvae attach , and develops
into adults .
 Females lay 3000-5000 eggs daily.
 Worms can pierce capillaries , cause localized
hemorrhage and allow bacteria to leave intestine.

8. CLINICAL FEATURES :
 Frequently asymptomatic.
 Clinical sign and symptoms –
adult worms (pathogenic stage)
Dependent on no. of worms none to digestive disturbances , bloody
(frank) mucoid dirrhoea , abdominal pain distention, rectal prolapse ,
and weakness.
• Severe infections :
Tenesmus and rectal prolapse in children
Can be fatal in children
Rarely, elephantiasis in adult.

9.  Trichuris trichura in large intestine.
 Many worms are present, each with its anerior end
embedded in the intestinal mucosa, resulting in the
erythema.

10. LAB- DIAGNOSIS:
 Stool :
Direct examination (iodine satin).
Eggs.
Rarely adult worms.
 Blood: eosinophilia
 Histopathology of the intestinal mucosa
 PCR

11. IMAGING :
 X-Rays Abdomen :
Plain
With contrast/dye
 CT Scan

12. TREATMENT AND PREVENTION
 Albindazole 400mg once.
 Mebendazole 100mg BD for 3 days.
(600 mg repeated after 2 weeks)
 Pay attention to personal hygiene and eating habits.