4General characteristics -bilaterally symmetrical, unsegmented and elongated,-The body is covered with a non cellular cuticle.-The sex is separated ( bisexual the )female is longer than the male.-Size varies from less than one mm to several centimeters.-Digestive system is complete with mouth, gut & anus.-Nervous system is very simple.-Reproductive system is well developed.The fundamental stages in are the egg , larva & the adult..
10Mode of transmission 1-Anus to mouth by: a-contaminated finger: (reinfection).b-contaminated night clothes, bed linen, etc.2-Airborne.3-Retroinfection.4-People sleeping in the same bed or bedroom,also contaminated toilet seat and wears.
11Pathology and clinical manifestations Majority of infections are asymptomatic.-Pruritis ani is main clinical manifestation, which results from:1-tickiling sensation from the emergence of the adult female worm.2-biproduct of adult worms.3-sticky albumin material coated the eggs.-Perianal excoriation, abdominal pain, appendicitis and eosinophilia are other manifestations.
12Behavioral changes -nail biting, -nose picking, -grinding of teeth during night,-inattention and poor cooperationnervousness, night mare, insomnia, anorexia, loss of weight, tiredness and dark shadow under the eye.
13Ectopic enteropiasis -Ectopic migration of worms may cause -vaginitis, -omentiti,-cervisitis,-peritonitis and-recurrent UTI.
14Diagnosis 1-History and clinical finding: 2-Specific diagnosis by detection of:-Adult worms in a-stool (on the surface).b-peri-anal area-Eggs: bya-Scotch tape slide method:95% of infected cases.b-Stool examination:5% of infected cases
15Treatment-Mebendazole (vermox) repeated after 7-10 days. -All family must be treated. -All bed lines & towels washed in hot water & the home must be cleaned.
16Trichuris trichiura (Whipworm) -It occurs worldwide.-most common in warm moist climates and areas where sanitation is poor.
17Trichiuris trichiura: adult worms (female and male)
20Pathogenesis and clinical features -Abdominal pain, weight loss, or epigastric pain.-Rectal prolapsed (probably due to toxic irritation of nerve endings).-Anaemia due to heavy worm load.-Malnutrition.-Bloody diarrhea.-Acute appendicitis due to mechanical blockage.-Eosinophilia
21Diagnosis 1-Stool examination a-typical barrel shaped eggs. b-occasionally an adult worm may appear in stool.2-SigmoidoscopyIn heavy infection, sigmoidoscopy may show the white bodies of the worm hanging from the inflamed mucosa- the so called coconut cake rectum.