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    012-Trichuris Trichiura and Enterobius

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    Ayop Kh
    1. Enterobius vermicularis, Ascaris lumbricoides, Trichuris trichiura, and Taenia saginata infections can cause appendicitis. Enterobius vermicularis commonly affects children. 2. Albendazole treatment should be repeated after 2 weeks for Enterobius vermicularis. All family members should be treated simultaneously to prevent reinfection. 3. If the child had eaten green salad, Trichuris trichiura is the probable parasite causing appendicitis, as ingestion of contaminated vegetables can transmit its eggs. Stool analysis and peri-anal swab can detect characteristic eggs to confirm the diagnosis.

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    012-Trichuris Trichiura and Enterobius

    Uploaded by

    Ayop Kh
    99 views15 pages
    1. Enterobius vermicularis, Ascaris lumbricoides, Trichuris trichiura, and Taenia saginata infections can cause appendicitis. Enterobius vermicularis commonly affects children. 2. Albendazole treatment should be repeated after 2 weeks for Enterobius vermicularis. All family members should be treated simultaneously to prevent reinfection. 3. If the child had eaten green salad, Trichuris trichiura is the probable parasite causing appendicitis, as ingestion of contaminated vegetables can transmit its eggs. Stool analysis and peri-anal swab can detect characteristic eggs to confirm the diagnosis.

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    012-Trichuris trichiura and Enterobius

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    1. Enterobius vermicularis, Ascaris lumbricoides, Trichuris trichiura, and Taenia saginata infections can cause appendicitis. Enterobius vermicularis commonly affects children. 2. Albendazole treatment should be repeated after 2 weeks for Enterobius vermicularis. All family members should be treated simultaneously to prevent reinfection. 3. If the child had eaten green salad, Trichuris trichiura is the probable parasite causing appendicitis, as ingestion of contaminated vegetables can transmit its eggs. Stool analysis and peri-anal swab can detect characteristic eggs to confirm the diagnosis.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    99 views15 pages

    012-Trichuris Trichiura and Enterobius

    Uploaded by

    Ayop Kh
    1. Enterobius vermicularis, Ascaris lumbricoides, Trichuris trichiura, and Taenia saginata infections can cause appendicitis. Enterobius vermicularis commonly affects children. 2. Albendazole treatment should be repeated after 2 weeks for Enterobius vermicularis. All family members should be treated simultaneously to prevent reinfection. 3. If the child had eaten green salad, Trichuris trichiura is the probable parasite causing appendicitis, as ingestion of contaminated vegetables can transmit its eggs. Stool analysis and peri-anal swab can detect characteristic eggs to confirm the diagnosis.

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    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    of 15

    Trichuris trichiura Trichuriasis

    hair tail
    ♂ ♀
    3cm 4cm

    Ingestion of contaminated
    green vegetables with
    Whip-like embryonated Trichuris egg
    Geographical Distribution: cosmopolitan
    Definitive host: Man Rhabditiform
    Habitat: caecum & adjacent parts larva
    Infective stage
    Embryonated egg
    Geohelminthic infection
    Develop on the ground Diagnostic stage
    Egg in stool
    Diagnostic Stage Infective Stage

    Embryonated egg
    S 50X25 µ Egg containing
    Barrel-shaped rhabditiform larva
    S Thick-shelled
    Mucoid plug‫د مخاطى‬77‫س‬ Mode of Infection
    at each pole
    C brownish Ingestion of embryonated
    egg in contaminated food
    C Immature ovum or drink
    Pathogenesis and Clinical Picture
    Inflammation & irritation of the mucosa with
    haemorrhages. Submucosal abscesses & ulcers.
    Mild infection: asymptomatic

    Moderate infection: nausea, vomiting,


    bloody diarrhoea & lower abdominal pain.

    Heavy infection (complications):


    1- Dysentery:
    Anterior part of worms embedded
    in intestinal mucosa cause
    oedematous, hyperaemic, fragile
    mucosa. Stool with mucus and
    blood.
    2- Perforation

    Peritonitis

    3- Invasion of appendix

    Appendicitis
    Blood loss
    Microcytic hypochromic
    4- Anaemia anaemia
    Due to Toxic byproducts of the worm
    Macrocytic hyperchromic
    5- Eosinophilia anaemia

    6- Rectal prolapse

    Normal rectum Rectal prolapse


    Anal tone Anal tone is lost Patient with rectal prolapse
    is present due to infection showing Trichuris worms
    Diagnosis
    1- Stool analysis
    to detect eggs

    2- Rectal examination
    by proctoscopy
    ‫منظار شرجى‬

    3- Air-contrast barium enema.


    4- Blood examination: anaemia and eosinophilia

    Treatment Epidemiology and control


    Albendazole As in Ascaris
    Enterobius vermicularis Enterobiasis
    intestine live worm
    Called: pin worm ‫لدودة‬77‫ا‬
    ‫دبوسية‬‫ل‬77‫ا‬
    Geographical Distribution: cosmopolitan.
    Definitive host: man only
    Habitat: caecum and adjacent parts.
    Diagnostic stage: egg
    S: 50 X 20 µ
    ♂
    S: plano-convex Plane Convex
    ♀ 5 mm
    10 mm long
    has 2 layers long
    covered with outer sticky
    albuminous layer Eggs are found mainly on
    C: translucent perianal skin.
    C: rhabditiform larva
    Mode of infection in Enterobiasis

    Female
    migrates
    during
    ♀ night
    ♂
    Ingestion of eggs by:
    Autoinfection (hand to mouth)
    Contaminated food or drink
    Handling contaminated linen,
    clothing and articles.
    Rhabditiform larva
    Air-born in dust
    Retro-infection Eggs are infective in few hours
    Pathogenesis and Clinical Picture

    • Sticky egg laid in the perianal


    region at night causes
    Pruritus ani.

    • Pruritus ani leads to


    nervous irritability, hyperactivity
    and insomnia (‫لليل‬77‫ا‬777‫)أرقب‬
    Pathogenesis and Clinical Picture
    • Female worms may migrate to ectopic sites stimulates:
    Granuloma formation
    Fallopian
    tube

    Peritoneal
    uterus cavity
    vagina
    urethra
    appendix
    Urinary infection Appendicitis Vulva-vaginitis
    (Involuntary micturition) Intestine Pelvic peritonitis
    ‫لالإرادى‬77‫لتبولا‬77‫ا‬ diarrhoea & abdominal pain
    Secondary enuresis
    Diagnosis
    Clinically: pruritus ani at night.

    Laboratory:
    - Swabbing of perianal area to detect
    the eggs by: NIH swab Cellophane

    NIH swab
    Scotch adhesive tape
    - Adults may be seen in stool
    or anal area.

    - Eggs are rarely found in stool


    Treatment
     Albendazole.

     It should be repeated after 2 weeks.

     All members of the family should be simultaneously


    ‫وقت‬
    ( ‫ل‬77‫فسا‬77‫ىن‬777‫ )ف‬treated.

     Application of white mercury oxide (white


    precipitate ointment) around the anus at night.
    Relieves itching, kills female worms coming out of
    the anus and prevents dispersal 7‫بعثر‬777‫ ت‬of eggs.
    Epidemiology
    • Eggs become mature and infective in few hours.
    • Pruritus leads to autoinfection.
    • Prevalent in Egypt
    (common in children and old age)

    Prevention and Control


    • Mass treatment.
    • Personal hygiene and food protection.
    • Infected children should use tightly fitting trousers
    at night.
    Short Question
    Appendicitis is a common clinical presentation facing Surgeons.
     Enumerate four helminthic infections that may be accompanied
    by appendicitis.
    Ascaris lumbricoides Trichuris trichiura
    infection. infection.

    Enterobius vermicularis Taenia saginata


    infection. infection.

     Choose one that commonly affects children.


    How can you treatAlbendazole
    this in both infections
    infection?
    Enterobius vermicularis infection Drug is repeated (2 w later)
    Ascaris lumbricoides infection Drug is given to all family
    Treated first in mixed infection
    Case
    A young boy was playing with his friends a football
    match. Suddenly he felt acute abdominal pain. His
    mother took him to the doctor. The condition was
    diagnosed as a case of acute appendicitis.
    a- What are the probable parasites that may cause this condition?
    Taenia Trichuris Enterobius Ascaris
    b- If the mother gave a history that her child had eaten green
    salad, what will be the probable parasite that has caused this
    condition?
    Ascaris Trichuris Enterobius
    c- How can you confirm your diagnosis?
    Stool analysis to detect of characteristic eggs
    Performing peri-anal swab for detection of Enterobius eggs

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