Enterobiasis may be asymptomatic and diagnosed incidentally, with worms being observed in the perineal area. If any, symptoms consist of anal and/or vulvar pruritus, that may be very intense and constitute the main complaint. Scratching may lead to the appearance of excoriations, that sometimes become infected by bacteria. The perineum, anus or genitals may be erythematous or, in more severe cases, eczematous dermatitis may be diagnosed [1]. Furthermore, patients may have severe abdominal pain similar to that found in acute appendicitis [2], may be irritable and have nocturnal enuresis. Sleep is disturbed in this disease primarily because of the pruritus. Girls may present with vaginitis. Children may also develop teeth grinding, with subsequent dental consequences. Other possible symptoms and signs include inappetence, nausea, and vomiting.

If Enterobius vermicularis migrates into the female genital tract, it may cause uterus, ovary, fallopian tubes, or peritoneum granulomas [3]. Dissemination of the disease has also been described in the prostate, perianal tissue [4], epididymis [5], lungs [6], urinary bladder, spleen, liver, and conjunctival sac.

• Asymptomatic

  In most cases the infection is asymptomatic, but there are also cases described in which peritoneal enterobiasis can cause abdominal pain. A case report and review of the pertinent literature. [ncbi.nlm.nih.gov]

  – 127.23; asymptomatic Plasmodium parasitaemia as outcome: OR: 5.75; 95% CI: 1.21 – 27.41). [bmcinfectdis.biomedcentral.com]

  Pinworm infections often remain asymptomatic. The short-lived female worm (about 1 cm in length) deposits its eggs once on the perianal skin. Within hours these eggs become infectious with a first-stage larva. [parasite-diagnosis.ch]

• Enuresis

  CONCLUSIONS: This study is suggestive of the involvement of E. vermicularis in the aetiology of enuresis in Calabar. Children presenting with, especially, uncomplicated enuresis should be screened for enterobiasis. [ncbi.nlm.nih.gov]

  Furthermore, patients may have severe abdominal pain similar to that found in acute appendicitis, may be irritable and have nocturnal enuresis. Sleep is disturbed in this disease primarily because of the pruritus. Girls may present with vaginitis. [symptoma.com]

  2012 17 Fatal case of ectopic enterobiasis: Enterobius vermicularis in the kidneys. ( 21879805 ) 2012 18 Peritoneal enterobiasis causing endometriosis-like symptoms. ( 23157050 ) 2012 19 The post-treatment effects of enterobiasis on the occurrence of enuresis [malacards.org]

• Fever

  He reported no change in bowel movements and no nausea, vomiting, perianal itching, hematochezia, fever, or other systemic symptoms. The physical examination was remarkable only for mild tenderness on deep palpation in the right lower quadrant. [doi.org]

  […] is an old name for typhoid fever). [wordpandit.com]

  A large gathering of pinworms in the body comes intoxication, which entails lethargy, listlessness, decreased appetite, sometimes loose stools, and fever. [artlife.com.ua]

  nausea vomiting diarrhea headache burning when applied Amantadine (symmetrel) Rimantadine antiviral amantadine- earliest antiviral only active against influenza A used phrophalactically and therapeutically Rimantadine- has longer half life causes fever [freezingblue.com]

• Abdominal Pain

  In most cases the infection is asymptomatic, but there are also cases described in which peritoneal enterobiasis can cause abdominal pain. A case report and review of the pertinent literature. [ncbi.nlm.nih.gov]

  In a female patient: the pain is not associated with menstruation, can complain of right-sided pain with intercourse.[2] This is due to infestation of the appendix with Enterobius vermicularis. [2] Intestinal complications: acute abdominal pain in the [explainmedicine.com]

  The patient was treated with albendazole, and the abdominal pain resolved. Pain is uncommon but can occur in patients with E. vermicularis infections. The more common symptom of anal pruritus is seen in only 33 percent of patients. [doi.org]

  Your child has severe abdominal pain. When should I contact my child's healthcare provider? Your child has a decreased appetite. Your child has a fever. Your child has diarrhea. Your child has trouble sleeping. [drugs.com]

• Pruritus Ani

  Pruritus Ani which occurs usually at night At night, the female of the Enterobius vermicularis species that lives in the colon migrates out of the anus and deposits her eggs on the perianal skin. Eggs become infective within hours. [explainmedicine.com]

  One common symptom is intense pruritus ani that in some patients can lead to insomnia, restlessness and irritability. [ncbi.nlm.nih.gov]

  Diagnosis, most commonly made in the school-aged child after complaints of nocturnal pruritus ani, can be made either by a cellulose tape test or by parental or self-report. A number of effective antihelminthics are available for treatment. [pubmed.ncbi.nlm.nih.gov]

• Diarrhea

  Oxyuriasis's symptoms are extremely diverse in children, ranging from nausea, diarrhea, insomnia, irritability, recurrent cellulitis, loss of appetite, nightmares and endometritis. [ncbi.nlm.nih.gov]

  Thailand 10160 Bentham Science Publishers Bovornkitti caused Chulalongkorn University Citation Index conjunctivitis outbreak contamination in hot cryptosporidiosis Cryptosporidium cysticercosis days rhinocerebral dengue infection detected diagnosis diarrhea [books.google.com]

  There is no relationship between detection of enterobiasis and CD4+ status [ 4 ] or presentation of diarrhea [ 4, 10 ]. [hiv.imedpub.com]

  Your child has diarrhea. Your child has trouble sleeping. Your child's anus becomes red and painful. You have questions or concerns about your child's condition or care. Care Agreement You have the right to help plan your child's care. [drugs.com]

  In the second group, 23,07% of the cases, predominating epigastralgia, dizziness and cephalea (migraine headache), diffuse abdominal pains and diarrhea. [repositorio.unifesp.br]

• Vomiting

  He reported no change in bowel movements and no nausea, vomiting, perianal itching, hematochezia, fever, or other systemic symptoms. The physical examination was remarkable only for mild tenderness on deep palpation in the right lower quadrant. [doi.org]

  Whereas side-effects in mentally retarded children are not as readily recognized as in a normal population, the only ill effects observed in this study were some looseness of stools, nausea, and vomiting. [ajtmh.org]

  Other possible symptoms and signs include inappetence, nausea, and vomiting. If Enterobius vermicularis migrates into the female genital tract, it may cause uterus, ovary, fallopian tubes, or peritoneum granulomas. [symptoma.com]

  Severe infestations very rarely result in abdominal pain, nausea, or vomiting. Why are pinworms so itchy at night? At night, the female adult pinworm leaves the anus to deposit eggs onto the skin around the anus. [dermnetnz.org]

  Your child may not have any symptoms, or he or she may have any of the following: Itching around the anus that is worse at night Irritability and trouble sleeping Decreased appetite, and losing weight without trying Nausea, vomiting, or diarrhea Abdominal [drugs.com]

• Nausea

  Oxyuriasis's symptoms are extremely diverse in children, ranging from nausea, diarrhea, insomnia, irritability, recurrent cellulitis, loss of appetite, nightmares and endometritis. [ncbi.nlm.nih.gov]

  He reported no change in bowel movements and no nausea, vomiting, perianal itching, hematochezia, fever, or other systemic symptoms. The physical examination was remarkable only for mild tenderness on deep palpation in the right lower quadrant. [doi.org]

  […] replication myopathy and phabdomyolysis immune reconstitutuion syndrome inflammatory response Nevirapine (viramune) antiretroviral NNRTI second class of antivirals indicated for treatment of HIV used wuth NRTI's well tolerated Adverse : rash, feve, nausea [freezingblue.com]

  Whereas side-effects in mentally retarded children are not as readily recognized as in a normal population, the only ill effects observed in this study were some looseness of stools, nausea, and vomiting. [ajtmh.org]

  Other possible symptoms and signs include inappetence, nausea, and vomiting. If Enterobius vermicularis migrates into the female genital tract, it may cause uterus, ovary, fallopian tubes, or peritoneum granulomas. [symptoma.com]

• Pruritus

  Pruritus Ani which occurs usually at night At night, the female of the Enterobius vermicularis species that lives in the colon migrates out of the anus and deposits her eggs on the perianal skin. Eggs become infective within hours. [explainmedicine.com]

  Sleep is disturbed in this disease primarily because of the pruritus. Girls may present with vaginitis. Children may also develop teeth grinding, with subsequent dental consequences. [symptoma.com]

  One common symptom is intense pruritus ani that in some patients can lead to insomnia, restlessness and irritability. [ncbi.nlm.nih.gov]

  Common symptoms of enterobiasis are intense pruritus ani and perineal pruritus that result when the female migrates to the anal area to lay eggs especially at night. Other symptoms include weight loss, loss of appetite, insomnia and restlessness. [biology-online.org]

• Dermatitis

  Scratching may cause skin irritation, and in more serious cases, eczematous dermatitis, haemorrhage or secondary bacterial infections. [ncbi.nlm.nih.gov]

  Fraga, Multinucleated giant cells in factitial dermatitis, Journal of Cutaneous Pathology, 40, 2, (206-208), (2013). Ran Thein, Mark E. [doi.org]

  As a result of scratches and a secondary bacterial infection may develop dermatitis with very persistent course; sometimes rapid pasty chair; often insomnia, neurasthenic and Psihologicheskii syndromes. [medicalency.com]

  The perineum, anus or genitals may be erythematous or, in more severe cases, eczematous dermatitis may be diagnosed. [symptoma.com]

• Pruritus Vulvae

  Presentation The presenting feature is often pruritus ani or pruritus vulvae, especially at night. Loss of sleep can cause behavioural problems. [patient.info]

  If patients are symptomatic, pruritus ani and pruritus vulvae are common presenting symptoms. See Presentation for more detail. Diagnosis of enterobiasis Eggs are usually deposited in great quantities on the perineum at night. [emedicine.medscape.com]

  This can cause vulvovaginitis, i.e. an inflammation of the vulva and vagina. This causes vaginal discharge and pruritus vulvae, i.e., itchiness of the vulva. [monsterologist.blogspot.com]

• Nocturnal Enuresis

  Furthermore, patients may have severe abdominal pain similar to that found in acute appendicitis, may be irritable and have nocturnal enuresis. Sleep is disturbed in this disease primarily because of the pruritus. Girls may present with vaginitis. [symptoma.com]

  Girls presenting before puberty with vaginal discharge, urinary tract infection, or nocturnal enuresis should be checked for threadworm. Do not immediately assume sexual abuse. [patient.info]

  Med. 14: 92 – 98 Ç ulha, G., D uran, N. (2006): The relationship between Enterobius vermicularis infection and nocturnal enuresis. Eur. J. Gen. [content.sciendo.com]

• Salpingitis

  Enterobius vermicularis salpingitis: a distant episode from precipitating appendicitis. Obstet Gynecol 1992 ; 80 : 553 –5. ↵ Kogan J, Alter M, Price H. Bilateral Enterobius vermicularis salpingo-oophoritis. [adc.bmj.com]

  E vermicularis can mimic other disease processes and, although rare, can lead to serious infectious complications such as tubo-ovarian abscesses. [5] The following complications have also been noted: appendicitis, endometritis, salpingitis, urethritis [emedicine.medscape.com]

• Irritability

  The patient was a 10-year old Syrian female, who presented with unusual and vague symptoms like insomnia and irritability. [ncbi.nlm.nih.gov]

  Disturbed sleep Nocturnal itch keeps the patients awake so they complain poor sleep. [1] Irritability and agitation Pruritus ani is a psychologically irritating symptom so people some people become irritable. [1] Secondary bacterial infections in the [explainmedicine.com]

  In girls, pinworms may cause vaginal itching and irritation. [msdmanuals.com]

• Insomnia

  The patient was a 10-year old Syrian female, who presented with unusual and vague symptoms like insomnia and irritability. [ncbi.nlm.nih.gov]

  Other symptoms include weight loss, loss of appetite, insomnia and restlessness. Enterobiasis is one of the most common worm infestations in humans. [biology-online.org]

• Seizure

  Many other conditions (eg, abdominal pain, insomnia, seizures) have been attributed to pinworm infestation, but a causal relationship is unlikely. [msdmanuals.com]

  Children may experience seizures, gnashing of teeth, scratching his nose distraction, inattention, anxiety, bedwetting. Girls itching and zapytanie pinworms in the genitals can lead to Masturbation and vulvovaginitis. [medicalency.com]

Parents may report seeing parasites on the child's perineum or on the surface of the feces. Female parasites are thin, white, about 10 mm long, while male parasites are half that size. Eggs can be found on the patient's perineum in the morning and can be captured if the transparent tape is placed on the area before the child bathes [7]. The next step is to observe them under a microscope. Eggs are described as ovoid and flat on one side. Samples should be obtained on three to five consecutive mornings [8]. Less reliable diagnostic methods are analyzing samples obtained from under the child's fingernails or asking the parent to inspect the perineal area of the child a few hours after he or she has fallen asleep, in order to observe live parasites. Stool samples are not routinely examined because eggs and adult parasites are seldom observed by this method.

In complicated cases, when granulomas are formed and need to be excised, they also can be studied. A histological analysis reveals inflammatory infiltrates, giant cells, lymphocytes, and numerous eosinophils. All these elements, in addition to fibrous tissue and necrotic material, are present around calcified parasite eggs [9]. A nodule that does not need to be excised can be punctured by fine needle aspiration [10]. In endemic areas, appendices excised for various reasons should also be analyzed [11]. Blood workup is usually noncontributory in uncomplicated cases, as eosinophilia is absent.

Enterobiasis is thought to be underreported, therefore its morbidity is difficult to be established [12].

During this treatment time and two weeks after final treatment, it is a good idea to avoid co-bathing and the reuse or sharing of washcloths. Showering may be preferred to avoid possible contamination of bath water. [cdc.gov]

The treated subjects were re-assessed post-treatment to ascertain whether they were cured and also to determine their enuretic status (for the enuretics). [ncbi.nlm.nih.gov]

(Outcomes/Resolutions) The prognosis of Enterobiasis is typically good, since the infection is asymptomatic in most cases. [dovemed.com]

Prognosis The prognosis is excellent, but reinfestation is common. Morbidity/mortality Secondary bacterial skin infection may develop from vigorous scratching to relieve pruritus. Reinfestation is common. [emedicine.medscape.com]

Prognosis Pinworms cause little damage and can be easily eradicated with proper treatment. Full recovery is expected. KEY TERMS Anus — The opening through which feces are eliminated. [encyclopedia.com]

Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. [icd10coded.com]

Treatment should be directed at the underlying etiology. Once these have been excluded, both general and specific measures must be initiated. [doi.org]

Our results add further knowledge to the epidemiology of intestinal parasites in day care centers. [ncbi.nlm.nih.gov]

Epidemiology Pinworm infections are more common within families with school-aged children, in primary caregivers of infected children, and in institutionalized children. [cdc.gov]

RØNNINGEN, Enterobius vermicularis and allergic conditions in Norwegian children, Epidemiology and Infection, 10.1017/S0950268813003154, 142, 10, (2114-2120), (2013). [doi.org]

Pathophysiology and Etiology The primary symptoms of pinworm infection include pruritus or a prickling sensation in the perianal area, which is produced when a gravid female pinworm migrates to the anal area and inserts her tail pin into the mucosa for [emedicine.medscape.com]

Pathophysiology: Usually, no symptoms occur when pinworms inhabit the caecum and adjacent areas. Diarrhea can occur during acute infection because of inflammation of the bowel wall. [lecturesofmedicine.blogspot.com]

How can pinworm infection and reinfection be prevented? Strict observance of good hand hygiene is the most effective means of preventing pinworm infection. [cdc.gov]

Teach children the importance of washing hands to prevent infection. [barnstablecountyhealth.org]

The study therefore showed that educating high risk individuals played a key role in the prevention of enterobiasis. [ncbi.nlm.nih.gov]

Moreover, reinfection increases the financial burden placed on preventative medicine programs. [journals.plos.org]

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