1/21. thiabendazole-induced toxic epidermal necrolysis. Toxic epidermal necrolysis (TEN) is a syndrome that may develop from a number of different stimuli, including drug administration, staphylococcal infection, vaccine administration, and blood dyscrasias. A 29-year-old woman developed TEN from the systemic administration of thiabendazole. Although various cutandous adverse reactions have been attributed to the administration of this medication, this is the first case to indicate that orally administered thiabendazole may also produce TEN. Although acutely ill at the time of hospitalization, the patient showed a prompt response to treatment with prednisone. ( info) |
2/21. trichuris vulpis recovered from a patient with chronic diarrhea and five dogs. We report a case of human infection with the whipworm of dogs, trichuris vulpis, in a woman with duodenal ulcer disease, chronic diarrhea, and close contact with dogs. Morphologically, T. vulpis ova resemble those of the human whipworm (T. trichiura) but are nearly twice their size. ( info) |
| A rare human case of gastroenteritis and eosinophilic ascites associated with gastric trichuriasis is described. The patient was a 32-yr-old woman who was working in a farm near Pohang, korea. She complained of abdominal pain, diarrhea, and vomiting. Endoscopic examination found focal linear hyperemia on the mucosa of the stomach antrum, and endoscopic biopsy confirmed eosinophilic inflammation of the mucosa and submucosa of the stomach, terminal ileum, and cecum. The biopsy specimen of the stomach included a female trichuris trichiura which was covered by many inflammatory cells on its surface. ascites and intestinal wall thickening was found by CT scan, and Douglas pouch centesis aspirated bloody ascites which included many eosinophils. She was medicated with prednisolone and albendazole and cured. She is the first case of eosinophilic inflammation of the gastrointestinal tract and ascites associated with trichuriasis in the stomach. ( info) |
4/21. Does whipworm increase the pathogenicity of campylobacter jejuni? A clinical correlate of an experimental observation. campylobacter jejuni is a leading cause of acute diarrhea worldwide, usually mild and self-limiting. No adequate hypothesis has yet been formulated to explain why in an otherwise healthy host this infection is occasionally severe. In a pig model, C jejuni has been shown to be pathogenic only in the presence of swine whipworm. A human case of life-threatening C jejuni colitis leading to toxic megacolon and acute renal failure, associated with concomitant whipworm (trichuris suis) ova in the feces, is reported. The potential of T suis to potentiate C jejuni in humans deserves further study. ( info) |
| The differential diagnosis of chronic diarrhea is extensive and requires the investigation of several diseases, such as celiac disease, inflammatory bowel disease and irritable bowel syndrome. A few patients infected by trichuris trichiura may present a chronic dysentery-like syndrome in the context of a massive infestation of the colon leading to anemia and growth retardation, but the rarity of that finding demands a high level of suspicion. Herein we report the case of an 8-year-old boy from the rural zone who had suffered diarrhea without blood or mucus for 4 years and was taken to our Service because his mother had noticed the presence of blood on the feces on the 3 previous months. The diagnosis of a massive trichuris trichiura infestation as the cause of the process was only reached by colonoscopy. We stress that trichuris trichiura infection can mimic other forms of inflammatory bowel disease and lead to physical growth retardation and that prolonged regimens of albendazole may be required to the effective treatment of massive infestations. ( info) |
| We report a case of biopsy-proven iatrogenic infection by the pig whipworm trichuris suis in a patient with crohn disease. The deliberate therapeutic ingestion of T suis ova has been adopted as an experimental approach to the treatment of crohn disease in an effort to promote a switch from the T helper subtype 1 to T helper subtype 2 inflammatory phenotype in vivo. This report examines the morphology of the immature and adult T suis, the effects of this intervention on the immunophenotype of the bowel mucosa, and it also raises the possibility of persistent active infection in man. ( info) |
7/21. Computed tomographic findings of trichuriasis. In this report, we present computed tomographic findings of colonic trichuriasis. The patient was a 75-year-old man who complained of abdominal pain, and weight loss. diagnosis was achieved by colonoscopic biopsy. Abdominal computed tomography showed irregular and nodular thickening of the wall of the cecum and ascending colon. Although these findings are nonspecific, they may be one of the findings of trichuriasis. These findings, confirmed by pathologic analysis of the biopsied tissue and Kato-Katz parasitological stool flotation technique, revealed adult trichuris. To our knowledge, this is the first report of colonic trichuriasis indicated by computed tomography. ( info) |
8/21. Caecal-caecal intussusception caused by trichuris trichiura in a young healthy adult. trichuris trichiura is a worldwide problem affecting millions of people. We report an unusual case of intussusception caused by T. trichiura that mimics acute appendicitis. The literature on T. trichiura associated intussusception is reviewed. ( info) |
9/21. Effectiveness of mebendazole in trichuris trichiura; a report on 2 cases of mild infection. Two admitted patients, a 5-year-old Filipino girl and a 29-year-old Indonesian man, who were diagnosed otherwise were concurrently found to harbour trichuris trichiura eggs in stoll specimens containing 3,300 and 30 eggs per gram feces (EPG), respectively. A satisfactory response was obtained with administration of mebendazole in the recommended dose of 100 mg twice daily for three consecutive days. Repeated post-treatment fecal examinations revealed 0 EPG. Adverse reaction, either physical or laboratory, due to the anthelmintic was negative. The study indicates that the effectiveness of mebendazole on mild infection with T. trichiura is excellent without any untoward effect. ( info) |
| The authors report a case of massive trichuris trichiura infection, resulting in severe anaemia and congestive cardiac failure in a 9-year-old Iban boy, who was resistant to the usual oral anthelmintic treatment, but promptly responded to mebendazole retention enema. This patient also had an associated entamoeba histolytica infection. ( info) |