Enterobius: Difference between revisions
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==Clinical Features== | ==Clinical Features== | ||
*Pruritus ani (intense itching of the perianal region) | *[[Pruritus ani]] (intense itching of the perianal region) | ||
**Worse at night | **Worse at night | ||
*Rarer symptoms include [[abdominal pain]], [[appendicitis]] and [[vulvovaginitis]] or [[dysuria]] in females | *Rarer symptoms include [[abdominal pain]], [[appendicitis]] and [[vulvovaginitis]] or [[dysuria]] in females | ||
Revision as of 23:42, 29 September 2019
Background
- Colloquially known as Pinworm (United States), Treadworm (UK and Australia) or Seatworm
- Medical infectious name: Enterobiasis
- Worldwide distribution
- Risk factors (prevalence can reach up to 50% in these populations):
- Age under 18
- Institutionalized
- Cohabitation with infected individual
- Humans only known reservoir
- Transmitted by fecal-oral route
- Can survive outside of body for up to 3 weeks
Clinical Features
- 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
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
- All family members should be treated at the same time
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
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