Abstract
Trichuris trichura (whip worm) is one of the most common intestinal parasite of humans in tropical countries. Often asymptomatic in humans, heavy infection can lead to chronic bloody diarrhoea associated with complications like rectal prolapse (particularly in children), appendicitis, colitis and proctitis. Very few cases of extensive Trichuriasis have been reported worldwide. We report a case of a 5-year-old girl who presented with generalized weakness, bleeding per rectum and rectal prolapse of 1 year duration. She was investigated for bleeding per rectum. Colonoscopy performed revealed extensive worm infestation involving the entire colon which was later confirmed as Trichuris trichura (whip worm) by microscopy. Child was diagnosed as Trichuris Dysentery Syndrome (TDS), treated for the same and discharged on improvement of the symptoms. The patient was traced back using the address available from the hospital records as she was not brought to the hospital for further follow up. Although none of her symptoms recurred, her stool microscopy however showed the presence of Trichuris trichura ova even at the end of 2 years indicative of persistent asymptomatic Trichuris trichura infection.
Highlights
Though most Trichuris trichura infections remain asymptomatic, a minority who have heavy parasitic infection become symptomatic which include anemia, diarrhoea and intestinal bleeding.[2] Rectal prolapse due to Trichuris trichura infection is rarely reported in patients with heavy parasite load
The simplest and easiest method of diagnosis of Trichuris trichura infection is based on the demonstration of characteristic bile stained barrel shaped egg in the stool, in some cases colonoscopy and computerized tomography are found to be helpful especially when they are being investigated for symptoms like intestinal bleed and rectal prolapse.[3]
We report a case of extensive and persistent chronic Trichuriasis in a child presenting with symptoms of anemia, bloody diarrhoea and rectal prolapse
Summary
Though most Trichuris trichura infections remain asymptomatic, a minority who have heavy parasitic infection become symptomatic which include anemia, diarrhoea and intestinal bleeding.[2] Rectal prolapse due to Trichuris trichura infection is rarely reported in patients with heavy parasite load. The simplest and easiest method of diagnosis of Trichuris trichura infection is based on the demonstration of characteristic bile stained barrel shaped egg in the stool, in some cases colonoscopy and computerized tomography are found to be helpful especially when they are being investigated for symptoms like intestinal bleed and rectal prolapse.[3]
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