Pinworms Disease

DESCRIPTION

Intestinal infection with Enterobius vermicularis. Characterized by perianal itching, usually worse at night.

System(s) affected: Gastrointestinal, Skin/Exocrine
Genetics: N/A
Incidence/Prevalence in USA: Approximately 20% of young children (ages 5-10)
Predominant age: 5 to 14
Predominant sex: Female > Male

SIGNS AND SYMPTOMS

Perianal itching
Perineal itching
Vulvovaginitis
Enuresis
Abdominal pain
Insomnia

CAUSES

The intestinal nematode Enterobius (Oxyuris) vermicularis

RISK FACTORS

Institutionalization (50-90% of institutionalized children have pinworms)
Crowded living conditions
Poor hygiene
Warm climate

LABORATORY

N/A

Drugs that may alter lab results: N/A
Disorders that may alter lab results: N/A

PATHOLOGICAL FINDINGS

Identification of ova on low power microscopy or direct visualization of the female worm (10 mm in length). Ova are asymmetric, flattened on one side, and measure 30 by 60 µm.

SPECIAL TESTS

Transparent tape test - a piece of transparent cellophane tape is adhered to the perianal skin in the early morning and then affixed to a microscope slide. This procedure must be performed at least 3 times to achieve 90% sensitivity. Alternatively, anal swabs or Swube Tubes (a pinworm paddle coated with adhesive material) can also be useful.
Flashlight to perianal region at night for direct observation
Digital rectal examination with saline slide preparation of stool on gloved finger

IMAGING

N/A

DIAGNOSTIC PROCEDURES

N/A

APPROPRIATE HEALTH CARE

Outpatient

GENERAL MEASURES

All symptomatic family members should be treated simultaneously
Bedclothes and underwear of infected individuals should be washed in hot water at the time of treatment (ova can remain viable for 2-3 weeks in a moist environment)
Strict hand washing can help prevent fecal-oral transmission
Practice good hygiene (showers, nail cleaning)
Topical use of antipruritic creams or ointments may help relive itching in the perianal region

SURGICAL MEASURES

N/A

ACTIVITY

No restrictions

DIET

No restrictions

PATIENT EDUCATION

For patient education materials on this topic: Centers for Disease Control, Dept. of Health and Human Services, Office of Public Affairs, Atlanta, GA 30333, (404)329-3534

PREVENTION/AVOIDANCE

Careful hand washing, keep nails short and clean
Wash anus and genitals at least once a day, preferably in a shower
Don't scratch anus or put fingers near nose or mouth

POSSIBLE COMPLICATIONS

Perianal scratching may cause impetigo or excoriation
Young girls - vulvovaginitis, urethritis, endometritis, salpingitis
Urinary tract infections

EXPECTED COURSE AND PROGNOSIS

Asymptomatic carriers are common
Symptomatic infections are cured > 90% of the time with drug therapy
Reinfection is common

ASSOCIATED CONDITIONS

Pruritus ani

AGE-RELATED FACTORS

Pediatric: More common in children and more likely to get reinfected
Geriatric: N/A
Others: N/A

PREGNANCY

Drug therapy is contraindicated in pregnancy

OTHER NOTES

N/A

ABBREVIATIONS

N/A

Clinical Investigations

ROLE OF HOMOEOPATHY

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