Trichuris trichiura - whipworm 鞭蟲

World-wide distributionCommonly found in tropical & subtropical regionsHigh infections rates in high risk groups

Male

Female

Adult Morphology成蟲形態

長約 30~45 mm尾部彎曲蟲體未端有一交尾剌

雄蟲

長約 35~50 mm尾部呈圓形子宮位於蟲體後半內含大量蟲卵

雌蟲

寄生於人體盲腸前端細長、約佔體長 3/5

口腔極小，具一尖刀狀口牙食道細長、外層為紋細胞 (stichocytes)

後端較粗腸道及生殖系統

Penetrates anddevelops in mucosa

Embryonated egg

Larva hatchesin intestine Adults in

caecum

Egg in feaces

Infectivestage

Diagnosticstage

MAN

EXTERNAL ENVORNOMENT

Female Male

1000-7000Eggs/day

3-5 weeks

Clinical Features 臨床徵候

成蟲寄生於盲腸，蟲體前端鑽入腸黏膜，後端游離於腸腔中，以腸細胞及宿主血液作食物

Clinical Features 臨床徵候

T. trichiura

成蟲寄生於盲腸，蟲體前端鑽入腸黏膜，後端游離於腸腔中，以腸細胞及宿主血液作食物

No recongizable clinical manifestations Parasite is discovered only on

routine stool examination

Light infection 輕度感染

No of worms > 800Systemic symptoms 全身性症狀Gastrointestinal symptoms 腸胃道症狀

Heavy infection 重度感染

Clinical Features 臨床徵候Heavy infection 重度感染

The worms are distributed throughout the colon 大腸

and rectum 直腸

Frequent small blood-streaked diarrhoeal stools 血痢,Abdominal pain and tenderness 腹痛,Nauesa 噁心 and vomiting 嘔吐,Occassional rectal proplase 脫肛

Gastrointestinal symptoms 腸胃道症狀

Systemic symptoms 全身性症狀

Anemia 貧血, eosinophilia 嗜酸性白血球增多 , malabsorption 吸收不良

male

female

Laboratory Diagnosis 實驗診斷

Finding eggs in feacesSigmoidoscopy 結腸鏡 or proctoscopy 直腸鏡

T. trichiura

Egg of T. trichiura黃棕色

大小約 50~54 x 25 µm呈紡錘形或酒桶形

卵殼厚

兩端各有一透明塞狀突起 (plug)卵內細胞尚未分裂