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Journal of Tropical Pediatrics Advance Access published online on July 6, 2005
Journal of Tropical Pediatrics, doi:10.1093/tropej/fmi073
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© The Author [2005]. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oupjournals.org

Original Papers

Massive Trichuris trichiura Infection as a Cause of Chronic Bloody Diarrhea in a Child

Daniel R. Diniz-Santos 1*, Jamile Jambeiro 1, Ramiro R. Mascarenhas 2, and Luciana R. Silva 1

1 Pediatric Gastroenterology and Hepatology Division, Professor Hosannah de Oliveira Pediatric Center, Federal University of Bahia, Salvador, Brazil
2 Digestive Endoscopy Division, Professor Edgard Santos Universitary Hospital, Federal University of Bahia, Salvador, Brazil

* To whom correspondence should be addressed.
Daniel R. Diniz-Santos, E-mail: danieldiniz82{at}ig.com.br


  Abstract

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.


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