Case #393 April 2015

A 59-year-old female immigrant presented at a local hospital with microcytic/hypochromic anemia and eosinophilia. She underwent an exploratory colonoscopy during which the following object shown in Figure A was observed and recovered. The object measured 40 mm in length. Results for routine ova-and-parasite (O&P) exams were not available. What is your diagnosis? Based on what criteria?A 59-year-old female immigrant presented at a local hospital with microcytic/hypochromic anemia and eosinophilia. She underwent an exploratory colonoscopy during which the following object shown in Figure A was observed and recovered. The object measured 40 mm in length. Results for routine ova-and-parasite (O&P) exams were not available. What is your diagnosis? Based on what criteria?

Figure A

This was a case of trichuriasis caused by Trichuris trichiura. The common name of T. trichiura is the human whipworm which is derived from the long, slender shape of the anterior portion of the adult worm, which resembles the lash of a whip. This is the part of the worm that threads into the mucosa of the human host. The posterior portion of the worm is thicker and is similar to the handle of a whip. Females have a blunt posterior end while that of males (as shown here) is coiled.