Korean J Gastroenterol.  2017 Apr;69(4):243-247. 10.4166/kjg.2017.69.4.243.

Trichuris trichiura Infection in North Korean Defector Resulted in Chronic Abdominal Pain and Growth Retardation

• Kim JB
• Seo KI
• Moon W

• KMID: 2383403
• DOI: http://doi.org/10.4166/kjg.2017.69.4.243

Abstract

Trichuris trichiura infection is a common helminth infection, which is transmitted via soil, with worldwide distribution, especially in rural areas of developing countries. Occasionally, sporadic cases occur in non-endemic, developed areas due to the widespread of immigration. We experienced a case of Trichuris dysentery syndrome in a young North Korean defector, who had been suffering from chronic abdominal pain for 10 years. He is relatively short and thin compared with his older brother. Unexpectedly, the diagnosis, made by a colonoscopy, revealed numerous, small, white, and gently moving worms at the cecum and ascending colon. After 3 days of albendazole (400 mg once daily) administration, clinical symptoms subsided dramatically. On the follow-up colonoscopy, which was performed two months after the completion of his treatment, complete eradication was identified. Soil-transmitted helminths, including Trichuris trichiura, are disappearing becoming less prevalent in South Korea as a result of both national driving force and environmental improvement. However, these diseases should be considered when we meet foreign patients from developing countries, like North Korea, presenting chronic abdominal pain. Moreover, proper treatment of North Korean defectors and performing cohort studies of them would help to prepare for the possible unification era in the field of gastroenterology.

Keyword

Trichuris trichiura; Growth retardation; Abdominal pain

MeSH Terms

Abdominal Pain*
Albendazole
Cecum
Cohort Studies
Colon, Ascending
Colonoscopy
Democratic People's Republic of Korea
Developing Countries
Diagnosis
Dysentery
Emigration and Immigration
Follow-Up Studies
Gastroenterology
Helminths
Humans
Korea
Siblings
Soil
Trichuris*
Albendazole
Soil

Figure

• 

  Fig. 1. Initial colonoscopy finding. Numerous, small, white, and gently moving worms attached to the cecal and ascending colonic mucosa were noted.

• 

  Fig. 2. (A) Section shows intestine and many eggs in the uterus of the adult female worm of Trichuris trichiura (H&E, ×200). (B) Trichuris trichiura eggs are barrel-shaped and measure 50 to 54 microns by 22 to 23 microns. The egg has a thick shell with brownish tinge and bipolar prominences (H&E, ×400).

• 

  Fig. 3. Follow-up colonoscopy. No parasitic infection signs were found.

Reference

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