Journal of Investigative Medicine High Impact Case Reports (Jan 2024)

An Unpleasant Souvenir: Whipworm as an Incidental Finding During a Screening Colonoscopy

  • Lefika Bathobakae MD, MPH,
  • Tyler Wilkinson MSc,
  • Saif Yasin BS,
  • Rammy Bashir MSc,
  • Nargis Mateen MD,
  • Ruhin Yuridullah MD,
  • Yana Cavanagh MD,
  • Walid Baddoura MD,
  • Jin Suh MD, FACP, FIDSA

DOI
https://doi.org/10.1177/23247096231224328
Journal volume & issue
Vol. 12

Abstract

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Trichuriasis is a neglected tropical disease caused by Trichuris trichiura that spreads through the ingestion of embryonated eggs in contaminated soil, water, or food. In nonendemic areas, T trichiura infestation is very rare and sporadic and is often diagnosed in immigrants from endemic countries such as the Philippines. Whipworms feed on human blood and also erode the colonic mucosa, thereby evoking an inflammatory response. In milder forms, trichuriasis can be asymptomatic and often an incidental diagnosis on screening colonoscopy. Heavily infested patients usually present with abdominal pain, nausea, vomiting, tenesmus, chronic diarrhea, iron deficiency anemia, or stunted growth. T trichiura worms can be removed with biopsy forceps during a colonoscopy; however, most patients require a course of albendazole, mebendazole, or ivermectin. We describe a unique case of T trichiura as an incidental finding during a screening colonoscopy. The whipworms were retrieved using biopsy forceps and the patient was treated with albendazole. At the time of the colonoscopy, the patient did not exhibit any specific symptoms related to the worm infestation.