Human infection by Trichostrongylus sp in Tunisia: Case report

Nematodes of the Trichostrongylus genus are primarily parasitic in herbivores, although sporadic zoonotic infections have been documented in various countries, including Iran, the Far East, and Australia. In Tunisia, one case has been reported, rendering this parasitic infection relatively unknown.

A 3-year-old female patient, congenitally monorenal, presented to the pediatric department at Charles Nicolle Hospital in Tunis with symptoms of anorexia, weight loss, and growth retardation. Hematological analysis revealed anemia concomitant with hypereosinophilia. The patient, originating from a rural region in Kasserin and currently residing in Tunis, had exposure to avian species, poultry, and sheep. Parasitological examination of stool samples, performed in our Parasitology and Mycology department, detected the presence of Trichostrongylus spp. eggs in two out of three specimens. A thorough family survey, including detailed interviews and stool parasitology, indicated no familial exposure to trichostrongylosis risk factors, and no parasitic eggs were found in the parents' samples.

Given the rarity or atypical nature of human infections with animal-derived hookworms, trichostrongylosis may be underrecognized, and the prevalence of common human hookworm infections might be overestimated. Enhancing environmental and personal hygiene and avoiding the consumption of raw vegetables in endemic regions are crucial preventive measures against this infection.