Enterobiasis

ETIOLOGY The cause of enterobiasis, or pinworm infection, is Enterobius vermicularis A small (1 cm in length), white, threadlike nematode. typically inhabits the cecum, appendix, and adjacent areas of the ileum and ascending colon Gravid females migrate at night to the perianal and perineal regions. Human infection occurs by the fecal-oral route .

EPIDEMIOLOGY occurs in individuals of all ages and socioeconomic levels It infects 30% of children worldwide. The prevalence of pinworm infection is highest in children 5–14 yr of age.

CLINICAL MANIFESTATIONS The most common complaints include itching and restless sleep secondary to nocturnal perianal or perineal pruritus. Eosinophilia is not observed in most cases because tissue invasion does not occur. occasionally may lead to appendicitis, chronic salpingitis, pelvic inflammatory disease,peritonitis, hepatitis, and ulcerative lesions in the large or small bowel.

DIAGNOSIS A history of nocturnal perianal pruritus in children strongly suggests enterobiasis Definitive diagnosis is established by identification of parasite eggs or worms Microscopic examination of adhesive cellophane tape pressed against the perianal region early in the morning frequently demonstrates eggs

TREATMENT mebendazole (100 mg PO for all ages) repeated in 2 wk results in cure rates of 90–100% a single oral dose of albendazole (400 mg PO for all ages) repeated in 2 wk a single dose of pyrantel pamoate (11 mg/kg PO, maximum 1 g).

PREVENTION Household contacts can be treated at the same time as the infected individual Repeated treatments every 3–4 mo may be required in circumstances with repeated exposure Good hand hygiene is the most effective method of prevention.