An unusual cause of overt gastrointestinal bleeding in a malnourished child

Area of Science:

• Medical Parasitology
• Pediatric Gastroenterology

Background:

• Trichuris trichiura (T. Trichiura) causes trichuriasis, a common parasitic infection in tropical children, often asymptomatic.
• Trichuris dysentery syndrome (TDS) is a severe manifestation, leading to mucous diarrhea, bleeding, malnutrition, stunting, and anemia.

Observation:

• A 7-year-old girl presented with a 2-year history of bloody diarrhea and failure to thrive.
• Clinical suspicion of inflammatory bowel disease was noted, with physical findings of pallor, edema, and hair changes.
• Stool examination revealed T. Trichiura eggs, and colonoscopy confirmed a massive worm load.

Findings:

• The patient was diagnosed with Trichuris dysentery syndrome (TDS).
• Massive Trichuris trichiura worm load was confirmed via colonoscopy.
• The child exhibited severe symptoms including bloody diarrhea, malnutrition, and anemia.

Implications:

• This case highlights the importance of considering parasitic infections in children with severe gastrointestinal symptoms and failure to thrive.
• Early diagnosis and appropriate antiparasitic treatment are crucial for managing TDS and preventing long-term complications.
• Successful treatment with Albendazole and blood transfusion underscores the efficacy of standard therapeutic interventions for severe trichuriasis.