Infectious Disease Compendium

Trichuris trichiura

Microbiology

A nematode, aka whipworm. It is a roundworm. There are other whipworms for other animals.

Epidemiologic Risks

Part of the human colon if you are from a third world county like, say, the US South. From the colon to the soil to the mouth to the small bowel to the colon and repeat.

Asia and Africa are more common parts of the world.

Syndromes

Usually asymptomatic, it can cause bloody diarrhea, anemia, and people to freak when they pass a worm which can be 2 inches long.

Treatment

albendazole 400 mg orally for 3 days

or

mebendazole 100 mg orally twice a day for 3 days

or

ivermectin 200 mcg/kg/day orally for 3 days

In children in a NEJM study, oxantel pamoate (20 mg per kilogram) plus of albendazole(400 mg) resulted in higher cure and egg- reduction than albendazole, mebendazole or oxantel pamoate (PubMed).

Combining either mebendazole (500 mg) or albendazole (400 mg) with ivermectin (200 mg/kg) all x 1 given better results in African children (PubMed), although in areas with high drug use, albendazole is of low efficacy (PubMed).

Notes

A single female can make 10,000 eggs a day. What married females can do is unknown.