Whipworm infection differential diagnosis: Difference between revisions

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__NOTOC__
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{{Whipworm infection}}
{{Whipworm infection}}
{{CMG}}; {{AE}} {{AKI}}
{{CMG}}; {{AE}} {{AKI}} {{MMF}}


==Overview==
==Overview==
[[Trichuris trichiura]] must be differentiated from other [[nematode]] infections such as [[ascariasis]], [[Hookworm|hook worm infection]] and [[Strongyloides stercoralis]] that can present with [[diarrhea]] and [[abdominal pain]].
[[Trichuriasis]] must be differentiated from other [[nematode]] infections such as [[ascariasis]], [[Hookworm|hook worm infection]] and [[Strongyloides stercoralis]] that can present with [[diarrhea]] and [[abdominal pain]].


==Differential Diagnosis==
==Differential Diagnosis==
[[Trichuris trichiura]] must be differentiated from other [[nematode]] infections such as [[ascariasis]], [[Hookworm|hook worm infection]] and [[Strongyloides stercoralis]] that can present with [[diarrhea]] and [[abdominal pain]].
[[Trichuriasis]] must be differentiated from other [[nematode]] infections such as [[ascariasis]], [[Hookworm|hook worm infection]] and [[Strongyloides stercoralis]] that can present with [[diarrhea]] and [[abdominal pain]].
{| class="wikitable"
{| class="wikitable"
! colspan="7" |Differentiating Trichuris trichiura infection from other Nematode infections<ref name="Principles and Practice">Durand, Marlene (2015). "Chapter 288:Intestinal Nematodes (Roundworms)". Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases Updated Edition, Eighth Edition. Elsevier. pp. 3199–3207. ISBN 978-1-4557-4801-3.</ref><ref name="Murray and Nadel's Textbook of Respiratory Medicine">{{cite book |last1=Kim |first1=Kami |last2=Weiss |first2=Louis |last3=Tanowitz |first3=Herbert |title=Murray and Nadel's Textbook of Respiratory Medicine Sixth Edition |publisher=Elsevier |date=2016 |pages=682-698 |chapter=Chapter 39:Parasitic Infections |isbn=978-1-4557-3383-5}}</ref>
! colspan="8" |Differentiating Trichuriasis from other Nematode infections<ref name="Principles and Practice">Durand, Marlene (2015). "Chapter 288:Intestinal Nematodes (Roundworms)". Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases Updated Edition, Eighth Edition. Elsevier. pp. 3199–3207. ISBN 978-1-4557-4801-3.</ref><ref name="Murray and Nadel's Textbook of Respiratory Medicine">{{cite book |last1=Kim |first1=Kami |last2=Weiss |first2=Louis |last3=Tanowitz |first3=Herbert |title=Murray and Nadel's Textbook of Respiratory Medicine Sixth Edition |publisher=Elsevier |date=2016 |pages=682-698 |chapter=Chapter 39:Parasitic Infections |isbn=978-1-4557-3383-5}}</ref><ref name="pmid21879805">{{cite journal| author=Serpytis M, Seinin D| title=Fatal case of ectopic enterobiasis: Enterobius vermicularis in the kidneys. | journal=Scand J Urol Nephrol | year= 2012 | volume= 46 | issue= 1 | pages= 70-2 | pmid=21879805 | doi=10.3109/00365599.2011.609834 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21879805  }} </ref>
|-
|-
|Nematode
! style="background:#4479BA; color: #FFFFFF;" |Infection
|Transmission
! style="background:#4479BA; color: #FFFFFF;" |Nematode
|Direct Person-Person Transmission  
! style="background:#4479BA; color: #FFFFFF;" |Transmission
|Duration of Infection
! style="background:#4479BA; color: #FFFFFF;" |Direct Person-Person Transmission  
|Pulmonary Manifestation
! style="background:#4479BA; color: #FFFFFF;" |Duration of Infection
|Location of Adult worm(s)
! style="background:#4479BA; color: #FFFFFF;" |Pulmonary Manifestation
|Treatment
! style="background:#4479BA; color: #FFFFFF;" |Location of Adult worm(s)
! style="background:#4479BA; color: #FFFFFF;" |Treatment
|-
|-
|[[Ascaris lumbricoides]]
| style="background:#DCDCDC;" align="center" |[[Trichuriasis]]
|Ingestion of infective ova
| style="background:#DCDCDC;" align="center" |[[Trichuris trichiura]]
([[whipworm]])
|Ingestion of infective [[ova]]
|No
|1-3 years
|
* No [[pulmonary]] migration, therefore, no pulmonary manifestation
|Anchored in the superficial [[mucosa]] of [[cecum]] and [[colon]]
|
* [[Albendazole]]
 
* [[Mebendazole]]
|-
| style="background:#DCDCDC;" align="center" |[[Strongyloidiasis]]
| style="background:#DCDCDC;" align="center" |[[Strongyloides stercoralis]]
|Filariform larvae penetrate [[skin]] or [[bowel]] [[mucosa]]
|Yes
|
* Lifetime of the host
|
* [[Löffler's syndrome]]
* Chronic [[cough]]
* [[Pneumonia]] or [[sepsis]] in hyperinfection
|Embedded in the mucosa of the [[duodenum]], [[jejunum]]
|
* [[Ivermectin]]
* [[Albendazole]]
* [[Thiabendazole]]
|-
| style="background:#DCDCDC;" align="center" |[[Ascariasis]]
| style="background:#DCDCDC;" align="center" |[[Ascaris lumbricoides]]
|Ingestion of infective [[ova]]
|No
|No
|1-2 years
|1-2 years
|
|
* [[Löffler's syndrome]] (usually about 9-12 days after exposure to ova)
* [[Löffler's syndrome]] (usually about 9-12 days after exposure to [[ova]])
* [[Cough]]
* [[Cough]]
* Substernal discomfort
* [[Substernal pain|Substernal]] discomfort
* [[Crackles]]
* [[Crackles]]
* [[Wheezing]]
* [[Wheezing]]
* Transient opacities
* Transient [[Opacity|opacities]]
|Free in the lumen of the small bowel
|Free air in the [[lumen]] of the [[small bowel]]
(primarily jejunum)
(primarily [[jejunum]])
|
|
* [[Albendazole]]
* [[Albendazole]]
Line 45: Line 77:
* [[Piperazine]]
* [[Piperazine]]
|-
|-
|[[Trichuris trichiura]]
| style="background:#DCDCDC;" align="center" |[[Hookworm Infection|Hookworm infection]]
(whipworm)
| style="background:#DCDCDC;" align="center" |[[Necator americanus]] and [[Ancylostoma duodenale]]
|Ingestion of infective [[ova]]
|[[Skin]] penetration by filariform larvae
|No
|No
|1-3 years
|No pulmonary migration, therefore, no pulmonary manifestation
|Anchored in the superficial mucosa of cecum and colon
|
|
* [[Albendazole]]
* 3-5 years ([[Necator americanus|Necator]])
 
* 1 year ([[Ancylostoma]])
* [[Mebendazole]]
|-
|[[Hookworm]] ([[Necator americanus]] and [[Ancylostoma duodenale]])
|Skin penetration by filariform larvae
|No
|
* 3-5 years (Necator)
* 1 year (Ancylostoma)
|
|
* [[Löffler's syndrome]]
* [[Löffler's syndrome]]
* Transient opacities
* Transient opacities
|Attached to the mucosa of mid-upper portion of the [[small bowel]]
|Attached to the [[mucosa]] of mid-upper portion of the [[small bowel]]
|
|
* [[Albendazole]]
* [[Albendazole]]
Line 76: Line 97:
* [[Pyrantel pamoate]]
* [[Pyrantel pamoate]]
|-
|-
|[[Strongyloides stercoralis]]
| style="background:#DCDCDC;" align="center" |[[Enterobiasis]]
|Filariform larvae penetrates skin or bowel mucosa
| style="background:#DCDCDC;" align="center" |[[Enterobius vermicularis]]
([[pinworm]])
|Ingestion of infective [[ova]]
|Yes
|Yes
|Lifetime of the host
|
|
* [[Löffler's syndrome]]
* 1-month
* Chronic [[cough]]
* [[Pneumonia]] or [[sepsis]] in hyperinfection
|Embedded in the mucosa of the [[duodenum]], [[jejunum]]
|
|
* [[Ivermectin]]
* Extraintestinal migration is very rare
* [[Albendazole]]
|Free air in the lumen of [[cecum]], [[appendix]], adjacent [[colon]]
* [[Thiabendazole]]
|-
|[[Enterobius vermicularis]] ([[pinworm]])
|Ingestion of infective [[ova]]
|Yes
|1 month
|Extraintestinal migration is very rare<ref name="pmid21879805">{{cite journal| author=Serpytis M, Seinin D| title=Fatal case of ectopic enterobiasis: Enterobius vermicularis in the kidneys. | journal=Scand J Urol Nephrol | year= 2012 | volume= 46 | issue= 1 | pages= 70-2 | pmid=21879805 | doi=10.3109/00365599.2011.609834 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21879805  }} </ref>
|Free in the lumen of [[cecum]], [[appendix]], adjacent [[colon]]
|
|
* [[Albendazole]]
* [[Albendazole]]

Revision as of 18:39, 24 July 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aravind Kuchkuntla, M.B.B.S[2] Furqan M M. M.B.B.S[3]

Overview

Trichuriasis must be differentiated from other nematode infections such as ascariasis, hook worm infection and Strongyloides stercoralis that can present with diarrhea and abdominal pain.

Differential Diagnosis

Trichuriasis must be differentiated from other nematode infections such as ascariasis, hook worm infection and Strongyloides stercoralis that can present with diarrhea and abdominal pain.

Differentiating Trichuriasis from other Nematode infections[1][2][3]
Infection Nematode Transmission Direct Person-Person Transmission Duration of Infection Pulmonary Manifestation Location of Adult worm(s) Treatment
Trichuriasis Trichuris trichiura

(whipworm)

Ingestion of infective ova No 1-3 years
  • No pulmonary migration, therefore, no pulmonary manifestation
 Anchored in the superficial mucosa of cecum and colon
Strongyloidiasis Strongyloides stercoralis Filariform larvae penetrate skin or bowel mucosa Yes
  • Lifetime of the host
 Embedded in the mucosa of the duodenum, jejunum
Ascariasis Ascaris lumbricoides Ingestion of infective ova No 1-2 years Free air in the lumen of the small bowel

(primarily jejunum)

Hookworm infection Necator americanus and Ancylostoma duodenale Skin penetration by filariform larvae No Attached to the mucosa of mid-upper portion of the small bowel
Enterobiasis Enterobius vermicularis

(pinworm)

Ingestion of infective ova Yes
  • 1-month
  • Extraintestinal migration is very rare
 Free air in the lumen of cecum, appendix, adjacent colon

References

  1. ↑ Durand, Marlene (2015). "Chapter 288:Intestinal Nematodes (Roundworms)". Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases Updated Edition, Eighth Edition. Elsevier. pp. 3199–3207. ISBN 978-1-4557-4801-3.
  2. ↑ Kim, Kami; Weiss, Louis; Tanowitz, Herbert (2016). "Chapter 39:Parasitic Infections". Murray and Nadel's Textbook of Respiratory Medicine Sixth Edition. Elsevier. pp. 682–698. ISBN 978-1-4557-3383-5.
  3. ↑ Serpytis M, Seinin D (2012). "Fatal case of ectopic enterobiasis: Enterobius vermicularis in the kidneys". Scand J Urol Nephrol. 46 (1): 70–2. doi:10.3109/00365599.2011.609834. PMID 21879805.

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