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Microbiology · Nematodes

Trichuris trichiura !

  • Parasite
  • Exam priority: high

A whip-shaped colon worm, the commonest soil-transmitted helminth in Colombian schoolchildren; heavy loads cause dysentery and rectal prolapse.

Updated 2026-11-01

Also called: whipworm

At a glance

Shape
Whip-shaped: long thin front end, thick back end
Family
Trichuridae
Type
Intestinal nematode (soil-transmitted helminth)
Size
Adults 3–5 cm

Morphology

  • Barrel- or lemon-shaped egg, 50–55 × 20–25 µm, with a polar plug at each end.
  • Thick brown shell; passed unembryonated.
  • The adult threads its thin end into the colonic mucosa.

Transmission

  • Swallowing embryonated eggs from faecally contaminated soil.
  • Dirty hands, poorly washed vegetables and unsafe water.
  • No direct person-to-person spread.

Reservoir: Humans; Contaminated soil

Isolation precautions

What the care team adds to standard precautions.

  • Standard

Life cycle

  1. Eggs leave in stool unembryonated.
  2. In soil they embryonate and become infective in about 15–30 days.
  3. Once swallowed, they hatch in the small bowel and larvae move to the caecum and ascending colon.
  4. The adult embeds its thin end in the colonic mucosa; there is no lung passage.
  5. The female lays thousands of eggs a day from 60–70 days on; adults live about a year.

Virulence factors

  • The embedded front end inflames the colonic mucosa and makes it bleed.
  • Heavy loads cause colitis with straining, tenesmus and blood.
  • Chronic straining on inflamed mucosa favours rectal prolapse in children.
  • Chronic blood loss adds to anaemia and stunting.

Diseases it causes

Clinical picture

  • Most infections are asymptomatic.
  • Dysentery syndrome with tenesmus at heavy loads.
  • Rectal prolapse with worms visible on the mucosa.
  • Anaemia, malnutrition and finger clubbing in intense chronic infection.

Diagnosis

  • Barrel-shaped eggs with polar plugs on stool microscopy; concentration recommended.
  • Kato-Katz to estimate intensity.
  • Proctoscopy or colonoscopy: worms attached to the mucosa.

Treatment

Benzimidazoles (albendazole or mebendazole); it responds less well than Ascaris to a single dose, so repeated courses or combinations with ivermectin are used.

Drug class only; doses and regimens are set by the clinician from the current guideline.

In Pharmacology:

Prevention

  • Sanitation, safe water and handwashing.
  • Washing fruit and vegetables.
  • Periodic school deworming in at-risk areas.

Test yourself

Think of the answer, then tap the question to see it.

What does the Trichuris trichiura egg look like?

Barrel-shaped, thick-walled, with a polar plug at each end.

Where does the adult Trichuris live?

In the caecum and ascending colon, with its front end embedded in the mucosa.

What classic complication does massive trichuriasis cause in children?

Rectal prolapse, often with worms visible on the prolapsed mucosa.

Which soil-transmitted helminth was most frequent in Colombia's national school survey?

Trichuris trichiura, in about 18% of children.

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Educational content on microorganisms; not a treatment guide and no substitute for a health professional's advice. No doses are given.

Sources: CDC - DPDx - Trichuriasis (CDC, 2024); Soil-transmitted helminth infections (WHO, 2023); Whipworm infection: MedlinePlus Medical Encyclopedia (MedlinePlus (NLM), 2024); Geohelmintiasis (Ministerio de Salud y Protección Social de Colombia, 2014).

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Representative model, for educational purposes only.