Enterobiasis

1. Enterobiasis

2. ETIOLOGY • The cause of enterobiasis, or pinworm infection, is Enterobiusvermicularis • Asmall (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 perinealregions. • Human infection occurs by the fecal-oral route .

3. 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.

4. CLINICAL MANIFESTATIONS • The most common complaints include itching and restless sleep secondary to nocturnal perianal or perinealpruritus. • 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.

5. DIAGNOSIS • A history of nocturnal perianalpruritus 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

6. 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 pyrantelpamoate (11 mg/kg PO, maximum 1 g).

7. 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.