While infections with Trichuris trichiura are often fairly benign, occasional patients may develop a heavy infestation with significant morbidity and even mortality. Ramsey describes a dysentery-like syndrome in children with trichuriasis and no other pathogens. The author is from the University of the West Indies.
Features of affected patients:
(1) infant or child with persistent, bloody diarrhea
(2) moderate to marked anemia (down to 2.8 g/dL)
(3) moderate eosinophilia (from 5-26%)
(4) rectal prolapse may occur, with worms adherent to the rectal mucosa
(5) numerous ova of Trichuris in the stool
For a definitive diagnosis, there should be an absence of other bacterial or parasitic pathogens. If other pathogens are present, then the significance of the trichuris depends on the relative number of each pathogen, and the clearance of symptoms after specific therapies.
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