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Trichuriasis – Diagnosis and Treatment

Trichuriasis is a parasitic infection which is caused by Trichuris trichiura, also known as the human whip worm. This primarily affects the large intestine of humans. This parasite survives in human and warm tropical climates and infects nearly 604 million people all over the world. This parasitic infection is transmitted via accidental ingestion of food infested with the larval eggs or drinking contaminated water. This disease primarily affects the children. Trichuriasis may also lead to serious health complications including physical growth retardation, anemia and malnutrition. Read on to know more about

diagnosis and treatment of trichuriasis

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Diagnosis of Trichuriasis

  • Rarely biopsy
  • Enzyme immunoassay

No specific tests are available to diagnose the infection in the intestinal stage. A muscle biopsy may help in detecting larvae and cysts in the second week of infection. Recent infection is indicated by diffuse inflammation in the muscle tissue.

The quickest way of detecting the infection is enzyme immunoassay using T. Spiralis excretory-secretory antigen. This test is used in the U.S. The tests have to be repeated as the initial results may be negative. This is because antibodies can not be detected in the first 3-5 weeks of infection. The other complementary tests are muscle biopsy and serological tests.

The muscle enzymes like LDH and creatine phosphokinase are enhanced in 50% of patients. This coincide with abnormal electromyograms. It is important to differentiate trichuriasis from:

  • Eosinophilia due to polyarteritis nodosa, eosinophilic leukemia, Hodgkin lymphoma
  • Neurologic manifestations of poliomyelitis, encephalitis and meningitis
  • Pneumonitis
  • Febrile illnesses like undulant fever, sepsis, typhoid fever and TB
  • Myositis, angioedema, acute arthritis and acute rheumatic fever

Treatment for Trichuriasis

  • Symptomatic treatment
  • Albendazole or Mebendazole to eradicate adult worms

Anthelmintics

help in eradicating adult worms present in the GI tract, although it has a little effect on the encysted larvae.

Analgesics

like opioids and NSAIDs can alleviate muscle pain. For treating CNS or myocardial involvement or allergic manifestations, prednisone can be administrated for 3-4 days. The dosage is 20-60 mg.

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