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Pinworm Infection

more about Pinworm Infection


Enterobiasis



  • An infection in the colon, which does not penetrate the bowel wall.  It is caused by a small, white roundworm, Enterobius vermicularis, which resides usually in the rectum of the human host.
  • At night, the female pinworm exits the anal orifice and lays eggs on the surrounding skin.
  • This is the most common parasitic infection in the U.S.

  • Perianal itching (itching around the anus), or itching around the vagina
  • Loss of appetite and therefore weight loss
  • Abdominal distress
  • Significant symptoms usually mean a heavy infestation.

  • Enterobius vermicularis

  • A family member might see the worms on the perianal skin of a child, or in the toilet after the patient's bowel movement.  The worms have a characteristically small size, white color, and thin body.  The length is about that of a pencil point.
  • In a child with perianal itching, a "tape test" or "pinworm prep" applies a piece of transparent tape to the perianal skin of a child, to adhere the eggs (which might not be visible).  The tape is then applied to a microscopic slide or other similar clear object, and the physician can then see the eggs under the microscope.  The eggs of Enterobius have a characteristic shape.
  • Other devices, available commercially, adhere the eggs in a manner easier for the patient's family to bring in the sample.
  • A first morning sample is most likely to yield the diagnosis, since the eggs are laid overnight.
  • The eggs can be collected from the dirt under a child's fingernail, after the child has been scratching, but this is a more burdensome way to obtain eggs for diagnosis.
  • In significantly ill patients, a stool sample submitted to a physician or laboratory might show infection with several varieties of worms, including pinworm, and the diagnosis would be made by seeing the characteristic egg microscopically in the stool sample (not on a pinworm prep).

  • Children of grade school age have the highest risk.
  • Transmission is via the oral anal cycle (see the infectious Diarrhea entry); therefore children in daycare centers are also at high risk.
  • Infective eggs can be transmitted from person to person, or their presence on bedding or clothing can transmit the infection when a new host touches the item and the eggs are then introduced into the mouth of the next host.
  • Eggs may also be inhaled from the air and swallowed.

  • Mebendazole (or pyrantel) is the commonest oral treatment, which is a single dose of a 100-mg. chewable tablet (effective in 90% of all cases).  Occasionally, the treatment needs repeating if there is a treatment failure.
  • All members of the family need treatment.
  • In cases of infection with multiple species of worms or other parasites, the sequence in which the parasites are killed is important.  One does not want to stimulate bowel contractions with one type of antihelmintic (medication against worms) if it would cause a second parasite in the bowel to migrate into other body parts.

  • Sensitivity to the medication might occur, but there are no common complications from the pinworm infection.
  • Rarely, extreme infestation can lead to Appendicitis, caused by pinworms' blocking the appendix.

  • Contact a physician.

  • Other intestinal parasitic infections, such as infection with other worms




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