Case #273 – April, 2010
A 68-year-old man underwent a routine colonoscopy at a local V. A. Medical Center. He had no complaints of illness but had recently traveled to Ethiopia. A worm-like object measuring approximately 30 millimeters in length was observed and recovered. Figures A and B show the whole worm viewed with a dissecting microscope. Figures C and D show what was observed using a compound microscope at 200x magnification. What is your diagnosis? Based on what criteria?
This was a case of trichuriasis caused by Trichuris trichiura, also known as the human whipworm. Diagnostic features included a short, thick posterior end and a long, slender, whip-like anterior end (Figures A and B). The coiled posterior end and the presence of a spicule (best seen in Figure D) indicate the specimen was a male. It was unknown at the time whether or not this was a single-worm or unisex worm case, but it should be noted that eggs may not be present during routine ova-and-parasite (O&P) examinations in such cases.
More on: Trichuriasis
This case and the specimen from which images were taken are courtesy of the Philadelphia V. A. Medical Center.
Images presented in the DPDx case studies are from specimens submitted for diagnosis or archiving. On rare occasions, clinical histories given may be partly fictitious.
DPDx is an educational resource designed for health professionals and laboratory scientists. For an overview including prevention, control, and treatment visit www.cdc.gov/parasites/.