Enterobius

Background

• Colloquially known as Pinworm (United States), Treadworm (UK and Australia) or Seatworm
  • Medical infectious name: Enterobiasis
• World wide 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 infection of the female genital tract

Diagnosis

• 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 pt'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

DDx

• Idiopathic pruritus ani
• Helminth infections
• Rectal Tenesmus

Treatment

• Single dose of Mebendazole or Albendazole
  • Second dose 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

See Also

• Parasites

Source

• http://www.cdc.gov/parasites/pinworm/
• Rosen's Emergency Medicine, Chapter 133, Parasitic infections
• Craig SA, Zich DK, “Gastroenteritis,” in Rosen’s Emergency Medicine Concepts and Clinical Practice, edited by Marx JA, Hockberger RS, Walls RM, et al., 1220. Philadelphia: Mosby, 2010.