Enterobius: Difference between revisions
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==Background==
==Background==
*Colloquially known as pinworm (United States), Treadworm (UK and Australia) or Seatworm
 
*World wide distribution
[[File:Enterobius vermicularis LifeCycle.gif|thumb|Enterobious vermicularis life cycle.]]
*Risk factors (prevalence can reach up to 50% in these populations):
*''Enterobius vermicularis''
**Age under 18
*Colloquially known as Pinworm (United States), Treadworm (UK and Australia), or Seatworm
**Institutionalized
*Worldwide distribution
**Cohabitation with infected individual
*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)
*Rarer symptoms include abdominal pain, appendicitis and infection of the female genital tract


==Diagnosis==
[[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.]]
*[[Special:MyLanguage/Pruritus ani|Pruritus ani]] (intense itching of the perianal region)
**Worse at night
*Rarer symptoms include [[Special:MyLanguage/abdominal pain|abdominal pain]], [[Special:MyLanguage/appendicitis|appendicitis]] and [[Special:MyLanguage/vulvovaginitis|vulvovaginitis]] or [[Special:MyLanguage/dysuria|dysuria]] in females
 
 
==Differential Diagnosis==
 
*Idiopathic pruritus ani
*Rectal tenesmus
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{{Helminth Types}}
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==Evaluation==
 
*Tape test  
*Tape test  
**Most common
**Most common
**Touch transparent tape to the perianal region and examine for eggs under the microscope
**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
*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
*Stool analysis does not work because of low egg burden in stool


==DDx==
*Idiopathic pruritus ani
*Helminth infections


==Treatment==
==Management==
*Mebendazole
 
*Albendazole
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{{Pinworms Treatment}}
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===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==
 
*[http://www.cdc.gov/parasites/pinworm/ CDC: Enterobiasis]
 


==See Also==
==See Also==
*[[Parasites]]


==Source==
*[[Special:MyLanguage/Parasites|Parasites]]
*[[wikipedia:Enterobiasis]]
*[[Special:MyLanguage/Pruritus ani|Pruritus ani]]
*[[wikipedia:Pinworm]]
 
*http://www.cdc.gov/parasites/pinworm/
 
*Rosen's Emergency Medicine, Chapter 133, Parasitic infections
==References==


<references/>


[[Category:ID]]
[[Category:ID]]
[[Category:TropMed]]
[[Category:Tropical Medicine]]
[[Category:GI]]
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Latest revision as of 22:51, 4 January 2026


Background

Enterobious vermicularis life cycle.
  • 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

Two pinworms next to a ruler: The markings are 1 mm apart.
Enterobius (pinworms) marked by arrows on the anus.


Differential Diagnosis

  • Idiopathic pruritus ani
  • Rectal tenesmus

Helminth infections

Cestodes (Tapeworms)

Trematodes (Flukes)

Nematodes (Roundworms)


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]

Pediatric

  • 2 years or older:
  • <2 years


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

  1. ↑ CDC Resources for Health Professionals. Accessed 5/9/2021. https://www.cdc.gov/parasites/pinworm/health_professionals/index.html
  2. ↑ CDC Resources for Health Professionals. Accessed 5/9/2021. https://www.cdc.gov/parasites/pinworm/health_professionals/index.html
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