Received March 02, 2009; Revised April 22, 2009; Accepted May 16, 2009.
Abstract
Trichuris trichiura, commonly referred to as a whipworm, has a worldwide distribution, particularly among countries with warm, humid climates. In Korea, trichuriasis was a highly prevalent soil-transmitted helminthiasis until the 1970s. However, the nationwide prevalence decreased to 0.02% in 2004 as a result of national control activities and improvement in the socioeconomic status of Koreans. Most infected individuals have no distinct symptoms, if lightly infected. The diagnosis is typically confirmed by detection of T. trichiura eggs on examination of a stool sample; few reports have described detection of the parasite during colonoscopy. Recently, we managed 4 patients with trichuriasis who were diagnosed by detection of the parasite on colonoscopy, and we reviewed the literature on the colonoscopic diagnosis of T. trichiura in Korea. We suggest that colonoscopy might be a useful diagnostic tool, especially when infected by only a few male worms with no eggs in the stool.
Keywords: Trichuris trichiura, trichuriasis, colonoscopy, literature review.
References
1.
Hong ST,Chai JY,Choi MH,Huh S,Rim HJ,Lee SH. A successful experience of soil-transmitted helminth control in the Republic of Korea. Korean J Parasitol 2006;44:177–185.
Kim JS,Park JS,Kim YW,Suk JH,Choi J,Kwak CH,Park SK,Park HU,Kim HS. Four cases of Trichuris trichiura infection in the colon. Korean J Gastroint Endosc 2003;27:158–161.
4.
Davis M,Matteson R,Williams WC. Radiographic and endoscopic findings in human whipworm infection (Trichuris trichiura). J Clin Gastroenterol 1986;8:700–701.
5.
Zachary PE,Cooke AR. Endoscopic diagnosis of whipworm. Am J Gastroenterol 1994;89:461.
6.
Chandra B,Long JD. Diagnosis of Trichuris trichiura (whipworm) by colonoscopic extraction. J Clin Gastroenterol 1998;27:152–157.
7.
Herman MA,Ukawa K,Sugawa C. Diagnosis and removal of cecal whipworm infection. Case report and review. Dig Dis Sci 2000;45:1639–1643.
8.
Yoshida M,Kutsumi H,Ogawa M,Soga T,Nishimura K,Tomita S,Kawabata K,Kinoshita Y,Chiba T,Fujimoto S. A case of Trichuris trichiura infection diagnosed by colonoscopy. Am J Gastroenterol 1996;91:161–162.
9.
Okamura S,Washida Y,Iesaki K,Hayashi S. Colonoscopic diagnosis of whipworm infection. Gastrointest Endosc 1993;39:215–216.
10.
Taguchi H,Yamamoto H,Miyata T,Hayashi Y,Sunada K,Sugano K. In vivo diagnosis of whipworm (Trichuris trichiura) with high-definition magnifying colonoscope (with video). Gastrointest Endosc 2008;68:37.
11.
Pampiglione S,Rivasi F,Rubbiani C. Cryptic infection by whipworm mimicking a sessile polyp of the colon. Ital J Gastroenterol Hepatol 1997;29:365–366.
12.
Lorenzetti R,Campo SM,Stella F,Hassan C,Zullo A,Morini S. An unusual endoscopic finding: Trichuris trichiura. Case report and review of the literature. Dig Liver Dis 2003;35:811–813.
13.
Lin AT,Lin HH,Chen CL. Colonoscopic diagnosis of whipworm infection. J Gastroenterol Hepatol 2005;20:965–967.
14.
Chang CW,Chang WH,Shih SC,Wang TE,Lin SC,Bair MJ. Accidental diagnosis of Trichuris trichiura by colonoscopy. Gastrointest Endosc 2008;68:154.
Elliott DE. Intestinal worms. In: Feldman M,Friedman LS,Brandt LJSleisenger & Fordtran's Gastrointestinal and Liver Disease. 8th ed. Philadelphia, USA: Saunders; 2006. pp. 2441-2442.
17.
Lee SH,Chai JY,Hong ST. Synopsis of Medical Parasitology. 1st ed. Seoul, Korea: Korea Medical Book; 1996. pp. 62-66.
18.
Keiser J,Utzinger J. Efficacy of current drugs against soil-transmitted helminth Infections: systemic review and meta-analysis. JAMA 2008;299:1937–1948.
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