Enterobius: Difference between revisions
Neil.m.young (talk | contribs) (Text replacement - "pt's" to "patient's") |
|||
| (14 intermediate revisions by 4 users not shown) | |||
| Line 1: | Line 1: | ||
==Background== | ==Background== | ||
*Colloquially known as Pinworm (United States), Treadworm (UK and Australia) or Seatworm | [[File:Enterobius vermicularis LifeCycle.gif|thumb|Enterobious vermicularis life cycle.]] | ||
*''Enterobius vermicularis'' | |||
*Colloquially known as Pinworm (United States), Treadworm (UK and Australia), or Seatworm | |||
*Worldwide distribution | *Worldwide distribution | ||
*Humans only known reservoir | *Humans only known reservoir | ||
*Transmitted by fecal-oral route | *Transmitted by fecal-oral route | ||
*Can survive outside of body for up to 3 weeks | *Can survive outside of body for up to 3 weeks | ||
===Risk Factors=== | |||
''Prevalence can reach up to 50% in these populations'' | |||
*Age under 18 | |||
*Institutionalized | |||
*Cohabitation with infected individual | |||
==Clinical Features== | ==Clinical Features== | ||
*Pruritus ani (intense itching of the perianal region) | [[File:Pinworm.jpg|thumb|Two pinworms next to a ruler: The markings are 1 mm apart.]] | ||
[[File:DSCB4096(anal worms or just toilet paper remainders@).jpg|thumb|Enterobius (pinworms) marked by arrows on the anus.]] | |||
*[[Pruritus ani]] (intense itching of the perianal region) | |||
**Worse at night | **Worse at night | ||
*Rarer symptoms include abdominal pain, appendicitis and | *Rarer symptoms include [[abdominal pain]], [[appendicitis]] and [[vulvovaginitis]] or [[dysuria]] in females | ||
==Differential Diagnosis== | |||
*Idiopathic pruritus ani | |||
*Rectal tenesmus | |||
{{Helminth Types}} | |||
== | ==Evaluation== | ||
*Tape test | *Tape test | ||
**Most common | **Most common | ||
| Line 23: | Line 33: | ||
*Stool analysis does not work because of low egg burden in stool | *Stool analysis does not work because of low egg burden in stool | ||
== | ==Management== | ||
{{Pinworms Treatment}} | |||
===Prevention=== | ===Prevention=== | ||
*Carefully hand washing after using the toilet, and before and after eating | *Carefully hand washing after using the toilet, and before and after eating | ||
| Line 38: | Line 41: | ||
*Launder all bedding every 3-7 days for three weeks | *Launder all bedding every 3-7 days for three weeks | ||
*Wash underwear and pajamas daily for two weeks | *Wash underwear and pajamas daily for two weeks | ||
==Disposition== | |||
*Outpatient treatment | |||
==External Links== | ==External Links== | ||
[http://www.cdc.gov/parasites/pinworm/ CDC: Enterobiasis] | *[http://www.cdc.gov/parasites/pinworm/ CDC: Enterobiasis] | ||
==See Also== | ==See Also== | ||
*[[Parasites]] | *[[Parasites]] | ||
*[[Pruritus ani]] | |||
==References== | ==References== | ||
| Line 50: | Line 57: | ||
[[Category:ID]] | [[Category:ID]] | ||
[[Category:Tropical Medicine]] | [[Category:Tropical Medicine]] | ||
[[Category:GI]] | |||
Latest revision as of 22:02, 16 April 2025
Background
- Enterobius vermicularis
- Colloquially known as Pinworm (United States), Treadworm (UK and Australia), or Seatworm
- Worldwide distribution
- Humans only known reservoir
- Transmitted by fecal-oral route
- Can survive outside of body for up to 3 weeks
Risk Factors
Prevalence can reach up to 50% in these populations
- Age under 18
- Institutionalized
- Cohabitation with infected individual
Clinical Features
.jpg)
- Pruritus ani (intense itching of the perianal region)
- Worse at night
- Rarer symptoms include abdominal pain, appendicitis and vulvovaginitis or dysuria in females
Differential Diagnosis
- Idiopathic pruritus ani
- Rectal tenesmus
Helminth infections
Cestodes (Tapeworms)
- Taenia saginata
- Taenia solium (Cysticercosis)
- Diphyllobothrium latum
- Hymenolepis nana
- Echinococcus granulosus
Trematodes (Flukes)
- Fasciola hepatica
- Fasciolopsis buski
- Opistorchis viverrini
- Schistosoma spp
- Chlonorchis sinensis
- Paragonimus spp.
Nematodes (Roundworms)
- Ascaris lumbricoides
- Enterobius vermicularis (Pinworm)
- Filarial worms
- Hookworm
- Necator americanus
- Ancylostoma duodenale
- Cutaneous larva migrans (Ancylostoma braziliense)
- Dracunculiasis
- Strongyloides stercoralis
- Trichuris trichiura (Whipworm)
- Anisakis
- Toxocara spp.
- Trichinosis
Evaluation
- Tape test
- Most common
- Touch transparent tape to the perianal region and examine for eggs under the microscope
- Can also test by examining scrapings under patient's fingernails or examining perianal region 2-3 hours after patient falls asleep
- Stool analysis does not work because of low egg burden in stool
Management
Treatment targeted against Enterobius vermicularis; All family members should be treated at the same time
Adult
- Mebendazole 100mg PO once, THEN repeat in 2 weeks OR
- Okay during breastfeeding[1]
- Albendazole 400mg PO once, THEN repeat in 2 weeks OR
- Pyrantel Pamoate (Pin-x) 11mg/kg (max 1g), THEN repeat in 2 weeks
- First choice for pregnant patients
- Treat in pregnancy only if the infection is compromising the pregnancy (i.e. weight loss, sleeplessness); withhold until the 3rd trimester if possible.[2]
- First choice for pregnant patients
Pediatric
- 2 years or older:
- Mebendazole 100mg PO once, THEN repeat in 2 weeks OR
- Albendazole 400mg PO once, THEN repeat in 2 weeks OR
- <2 years
- Albendazole 200 mg PO once, THEN repeat in 2 weeks
Prevention
- Carefully hand washing after using the toilet, and before and after eating
- Thoroughly launder all bedding, clothing, and toys to destroy any lingering eggs
- Launder all bedding every 3-7 days for three weeks
- Wash underwear and pajamas daily for two weeks
Disposition
- Outpatient treatment
External Links
See Also
References
- ↑ CDC Resources for Health Professionals. Accessed 5/9/2021. https://www.cdc.gov/parasites/pinworm/health_professionals/index.html
- ↑ CDC Resources for Health Professionals. Accessed 5/9/2021. https://www.cdc.gov/parasites/pinworm/health_professionals/index.html