Trichuriasis.

A 16-year-old female presented with a 6-month history of dysentery associated with subjective fevers and weight loss of 10 kg. Her laboratory testing was remarkable for a hemoglobin of 9.1 g/dL, leukocytosis with neutrophilia (no eosinophilia), C-reactive protein > 15 mg/L, serum albumin of 2.5 g/dL and a negative HIV ELISA test. In the months prior to her presentation, she had two stool testing, which revealed positive fecal occult blood and the presence of Trichuris trichiura eggs, for which she was treated with nitazoxanide twice and metronidazole once. Due to persistent symptoms despite treatment, she was referred to our facility, to rule out ulcerative colitis. At the time of this presentation, physical examination showed poorly localized abdominal pain. A colonoscopy revealed diffuse parasitic infiltration of the colonic mucosa (Video, Appendix A). A biopsy was performed, showing histopathological findings of infectious colitis, evidence of adult parasitic colonic infiltration (Fig. 1, Panel A), and the presence of a gravid female parasite of Trichuris trichiura (Fig. 1, Panel B, arrow). The patient was treated symptomatically and mebendazole was started [1], [2].

Fig. 1

Histopathological findings compatible with adult parasitic colonic infiltration of Trichuris trichiura (Panel A), with evidence of a gravid female parasite (Panel B, arrow).

Authorship

Dr. Carranza and Dr. Asturias contributed equally in the clinical management of this patient and in writing the case presentation.

Prior presentations/publications

None.

Funding source

There is no funding source for this manuscript.

Author statement

Dr. Carranza and Dr. Asturias contributed equally in the clinical management of this patient and in writing, and reviewing, the case presentation.

Author contribution

All authors contributed equally to the clinical management of the patient and to the writing of this report.

Declaration of Competing Interest

We declare no conflict of interest.