Diagnosis

Laboratory Studies

            

            Studies often reveal eosinophilia from ongoing tissue invasion (in contrast to all intestinal helminths except Strongyloides stercoralis).Rarely, studies show anemia.

            

            Characteristic eggs on stool smear (oval with transparent bipolar plugs) are visible.Each female produces up to 20,000 eggs per day. (No stool concentration technique is necessary.)

Imaging Studies

            Endoscopy often shows adult worms attached to the bowel mucosa.

Other Tests

            Obtain a stool smear for ova and parasites (as above).

Procedures

            

            No procedures are indicated in the absence of complications. However, endoscopy may be warranted in instances of severe anemia or refractory infection.

           
            Microscopic identification of the whipworm parasite eggs in feces is evidence of infection. Because eggs may be difficult to find in light infections, a concentration procedure is recommended. Because the severity of symptoms depend on the worm burden, quantification of the latter (e.g. with the Kato-Katz technique) can prove useful. Examination of the rectal mucosa by proctoscopy (or directly in case of prolapses) can occasionally demonstrate adult worms.

Egg stool smear

Macroscopic (Gross) Observations

            Adult males of Trichuris trichiura are 30-45 millimeters long, with a coiled posterior end. Adult females are 35-50 millimeters with a straight posterior end. Both sexes have a long, whip-like anterior end.  Adults usually reside in the large intestine, cecum and appendix of the host.

posterior end of an adult T. trichiura by colonoscopy

Refrences