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Key Features

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  • Trichuris trichiura is a widespread human and animal parasite common in children living in warm, humid areas conducive to survival of the ova

  • Ingested infective eggs hatch in the upper small intestine

  • Adult worms live in the cecum and colon; the ova are passed and become infectious after several weeks in the soil

  • Unlike Ascaris, Trichuris does not have a migratory tissue phase

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Clinical Findings

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  • Symptoms are not present unless the infection is severe, in which case pain, diarrhea, iron deficient anemia, and mild abdominal distention are present

  • Massive infections may also cause rectal prolapse and dysentery

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Diagnosis

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  • Detection of the characteristic barrel-shaped ova in the feces confirms the diagnosis

  • Adult worms may be seen in the prolapsed rectum or at proctoscopy; their thin heads are buried in the mucosa, and the thicker posterior portions protrude

  • Mild to moderate eosinophilia may be present

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Treatment

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  • Mebendazole (100 mg orally twice a day for 3 days) or albendazole (400 mg in a single dose for 3 days, or 200 mg in children 1–2 years of age) tends to improve gastrointestinal symptoms

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