People, Parasites, and Plowshares by Dickson Despommier William Campbell

Author:Dickson Despommier, William Campbell [Despommier, Dickson D.]
Format: epub
Publisher: Columbia University Press
Published: 2013-08-27T16:00:00+00:00

Figure 5.3 Trichuris trichiura embedded in the large intestine. Scanning electron micrograph.

Speaking of the clinical effects of heavy infection with trichuris, the following incident was shared with me by a renowned pediatrician and tropical medicine expert. After graduating from medical school, he served four years in the United States Navy as a pediatrician, caring for children of service members. While in transit from Japan to another port of call in East Asia, the ship picked up some Japanese civilians. Among them were a mother and child from one of the outer islands. He observed that the two-year-old daughter was irritable and crying as they boarded; nothing unusual here. But as soon as they got under way, the mother came to sickbay with her child in tow and related through a translator that she often “saw worms” on the infant’s bottom. Again, nothing odd about that, considering that pinworm (Enterobius vermicularis), the most common worm infection known to humankind, is ever-present in that age-group. “No,” she insisted, “big worms on her bottom!” When the doctor removed the diaper, lo and behold, there was the child’s rectum, everted and inflamed (fig. 5.7). What’s more, it was covered with big worms! The young clinician consoled the mother as he slipped on a pair of examining gloves and pushed the rectum back in place. He knew that severe infection with trichuris could result in a prolapse of the rectum, having seen one example of that in a rural pediatric clinic as a fourth-year student on a medical elective in Colombia. He assured the mother that treatment of the infection would solve the problem. She smiled and left the room confident that her child would be all right. After he closed the door, he did what every other U.S. naval officer likely would have done in that situation: he heaved up his lunch all over the examining table and couldn’t even think about food for the next two days.

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