A child is taken to the doctor because of a 2-week bout of abdominal discomfort and diarrheic stools. A fecal concentration reveals scores of bipolar eggs like the one shown, indicating a heavy parasite burden. Which of the following complications might occur if the child is not treated for this parasite?
(A) Asthmalike manifestations
(B) Blockage of the duodenum
(C) Extraintestinal infection
(D) Prolapse of the rectum
The answer is D: Prolapse of the rectum.
Oftentimes light infections of the human whipworm (Trichuris trichiura) are only treated palliatively; however, a child who is symptomatic and who harbors heavy parasite burdens should be aggressively managed. Failure to treat with an anthelminthic could theoretically result in rectal prolapse. Hypochromic anemia is a possibility, but pernicious anemia (the choice here) refers to the broad fish tapeworm, Diphyllobothrium latum. The human whipworm is small and resides in the large intestine, which would eliminate choice
C. Intestinal obstruction anywhere in the intestinal tract would be highly unlikely. The juvenile worms have no pulmonary phase like Ascaris and hookworms. Again, the adult worm resides in the large intestine and occasionally the appendix.