Infectious Disease Book

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Pinworm

Aka: Pinworm, Enterobius vermicularis, Enterobiasis
  1. Epidemiology
    1. Most common in children ages 5 to 14 years
    2. Most common Helminth infection in the United States
    3. Prevalence: 209 million children infected worldwide
      1. Worldwide, 30% of children are infected
  2. Pathophysiology
    1. Intestinal roundworm (nematode) infection
      1. Humans are only known host
    2. Transmission
      1. Fecal-oral transmission of eggs
    3. Larvae hatch in duodenum
    4. Worms live in ascending colon at cecum
      1. Female worms migrate to perineum at night
      2. May lay up to 15,000 eggs nightly
    5. Majority of eggs dry-out within 3 days
  3. Transmission
    1. Ingestion of Pinworm ova (20 day viability)
    2. Passed by fomites (hands, clothing, house dust)
    3. Female worms migrate to anus at night to deposit eggs
  4. Symptoms
    1. Perianal or perineal Pruritus worse at night
    2. May also cause vaginal irritation
    3. Restlessness at night
  5. Signs
    1. Small (0.5 to 1 cm) white worms at perianal area
  6. Differential Diagnosis
    1. See Pruritus Ani
    2. See Pruritus Vulvae
  7. Labs
    1. Pinworm Test
  8. Course
    1. Self limited; resolves by 6 weeks (unless reingested)
  9. Management
    1. Pyrantel pamoate (Pin-Rid, OTC)
      1. Dose: 11 mg/kg up to 1 gram PO for 1 dose
      2. Repeat dose in 2 weeks
      3. Avoid in pregnancy or age under 2 years old
      4. Available as over-the-counter medication, and only $20 per 2 dose course
    2. Mebendazole (Vermox, Emverm)
      1. Dose: 100 mg chewable for 1 dose
      2. Repeat dose in 2 weeks (per CDC and despite package insert)
      3. Avoid in first trimester of pregnancy or age under 1 year old
      4. Was not available as of 2012, and available as of 2016 at $740/course
    3. Albendazole (Valbazen, Albendazole)
      1. Dose: 400 mg PO for 1 dose
      2. Repeat dose in 2 weeks (age 2 or older)
      3. Avoid in first trimester of pregnancy or age under 1 year old
      4. As with Mebendazole, very expensive in U.S. (>$600/course)
  10. Management: Other measures
    1. Treat household contacts (esp. if 2 or more members affected)
    2. Encourage hand washing and morning shower or bath
    3. Clean all linen, clothing in hot water (eggs survive 2-3 weeks on objects)
  11. References
    1. Gilbert et al (2016) Sanford Guide to Antimicrobial Therapy, accessed IOS app 5/4/2016
    2. Kazura in Behrman (2000) Nelson Pediatrics, p. 1067-8
    3. (2016) Presc Lett 23(5): 28
    4. (2012) Presc Lett 19(3): 16
    5. Markell (1985) Pediatr Clin North Am 32(4):971-86 [PubMed]

Enterobiasis (C0086227)

Definition (MEDLINEPLUS)

Pinworms are small parasites that can live in the colon and rectum. You get them when you swallow their eggs. The eggs hatch inside your intestines. While you sleep, the female pinworms leave the intestines through the anus and lay eggs on nearby skin.

Pinworms spread easily. When people who are infected touch their anus, the eggs attach to their fingertips. They can spread the eggs to others directly through their hands, or through contaminated clothing, bedding, food, or other articles. The eggs can live on household surfaces for up to 2 weeks.

The infection is more common in children. Many people have no symptoms at all. Some people feel itching around the anus or vagina. The itching may become intense, interfere with sleep, and make you irritable.

Your health care provider can diagnose pinworm infection by finding the eggs. A common way to collect the eggs is with a sticky piece of clear tape. Mild infections may not need treatment. If you do need medicine, everyone in the household should take it.

To prevent becoming infected or reinfected with pinworms,

  • Bathe after waking up
  • Wash your pajamas and bed sheets often
  • Wash your hands regularly, especially after using the bathroom or changing diapers
  • Change your underwear every day
  • Avoid nail biting
  • Avoid scratching the anal area

NIH: National Institute of Allergy and Infectious Diseases

Definition (MSH) Infection with nematodes of the genus ENTEROBIUS; E. vermicularis, the pinworm of man, causes a crawling sensation and pruritus. This condition results in scratching the area, occasionally causing scarification.
Concepts Disease or Syndrome (T047)
MSH D017229
ICD9 127.4
ICD10 B80
SnomedCT 19722001, 360417007, 266221005, 187178006, 154412007, 266162007, 360419005
English Enterobiases, Enterobiasis, Threadworms, Enterobius vermicularis Infection, Enterobius vermicularis Infections, Infection, Enterobius vermicularis, Infection, Oxyuris vermicularis, Infections, Enterobius vermicularis, Infections, Oxyuris vermicularis, Oxyuris vermicularis Infection, Oxyuris vermicularis Infections, ENTEROBIUS VERMICULARIS INFECT, INFECT OXYURIS VERMICULARIS, INFECT ENTEROBIUS VERMICULARIS, OXYURIS VERMICULARIS INFECT, enterobiasis (diagnosis), enterobiasis, Enterobiasis threadworm, Enterobius vermicularis infection, threadworm infection, Enterobiasis [Disease/Finding], pinworm disease, pinworm infection, Seatworm infection, Pinworms, Threadworms - enterobiasis, Oxyuris vermicularis infection (disorder), Pinworm infection (disorder), Pinworm infestation, Pinworm infection, Enterobiosis, Infection by Enterobius vermicularis, Oxyuris vermicularis infection, Pinworm disease, Threadworm infection, Enterobiasis - threadworm, Enterobiasis (disorder), Infection by Enterobius vermicularis (disorder), Enterobius vermicularis; infestation, Oxyuris vermicularis; infestation, disease (or disorder); pinworm, infestation; Enterobius vermicularis, infestation; Oxyuris vermicularis, pinworm; disease, threadworm; infection, Infection by Enterobius vermicularis (disorder) [Ambiguous], Pinworm, Threadworm, threadworms, pinworms
Dutch draadworminfectie, enterobiasis draadworm, Enterobius vermicularis-infectie, Enterobius vermicularis; infestatie, Oxyuris vermicularis; infestatie, aandoening; aarsmade, aarsmade; aandoening, aarsmade; infectie, infestatie; Enterobius vermicularis, infestatie; Oxyuris vermicularis, enterobiasis, Enterobiasis, Enterobius-vermicularisinfectie, Oxyuris-vermicularisinfectie
French Infection à oxyure, Infection à un nématode, Oxyurose, Entérobiase, Infection à Enterobius vermicularis
German Madenwurminfektion, Enterobius vermicularis Infektion, Enterobiasis durch Bandwurm, Enterobiasis, Enterobius vermicularis-Infektion, Oxyuris vermicularis-Infektion
Italian Infezione da Ossiuri, Infezione da ossiuro, Enterobius vermicularis, Infezione da Enterobius vermicularis, Infezione da Oxyuris vermicularis, Enterobiasi
Portuguese Infecção por enteróbio, Oxiuríase, Enterobiasis vermicularis, Infecção por Enterobius vermicularis, Infecção por Oxyuris vermicularis, Enterobíase, Infeção por Enterobius vermicularis
Spanish Infección por Enterobious vermicularis, Enterobiasis por lombrices intestinales, Infección por oxiuro, infección por Oxyuris vermicularis, infección por oxiuro, infección por gusano filiforme, infección por Oxiurus vermicularis, infección por Oxyuris vermicularis (trastorno), enterobiasis (trastorno), enterobiasis, infección por Enterobius vermicularis (concepto no activo), infección por Enterobius vermicularis (trastorno), infección por Enterobius vermicularis, infección por oxiuros, Enterobiasis, Infección por Enterobius vermicularis, Infección por Oxyuris vermicularis
Swedish Springmaskinfektion hos människa
Japanese ギョウチュウショウ, ギョウチュウカンセン, 蟯虫症, ぎょう虫感染, ぎょう虫症, ぎょう虫感染症, 蟯虫感染, 蟯虫感染症
Finnish Kihomatotauti
Russian ENTEROBIUS VERMICULARIS INFEKTSIIA, ENTEROBIOZ, OXYURIS VERMICULARIS INFEKTSIIA, ENTEROBIUS VERMICULARIS ИНФЕКЦИЯ, OXYURIS VERMICULARIS ИНФЕКЦИЯ, ЭНТЕРОБИОЗ
Czech Enterobióza, Infekce parazitem Enterobius vermicularis, Infekce roupy, onemocnění dětským roupem, enterobióza, enterobiáza
Korean 요충증
Croatian ENTEROBIJAZA
Polish Zarażenie owsikiem ludzkim, Zarażenie Oxyuris vermicularis, Enterobioza, Owsica ludzi, Zarażenie Enterobius vermicularis
Hungarian Cérnagiliszta fertőzés, enterobiasis, Fonálféreg fertőzés, Enterobiasis fonálféreg, Enterobius vermicularis fertőzés
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Enterobius vermicularis (C0600211)

Concepts Eukaryote (T204)
MSH D004757
SnomedCT 55008000
LNC LP63172-8, MTHU025977
English Enterobius vermicularis, Oxyuris vermicularis, Pinworms, Enterobius vermiculari, vermiculari, Oxyuris, vermiculari, Enterobius, Oxyuris vermiculari, vermicularis, Oxyuris, vermicularis, Enterobius, enterobius vermicularis, threadworm, human pinworm, pinworm, pinworms, Pinworm, Threadworm, Scutate threadworm, Seatworm, Ascaris vermicularis, Ev - Enterobius vermicularis, Enterobius vermicularis (organism)
Dutch draadwormen, Enterobius vermicularis, Oxyuris vermicularis
French Oxyures, Oxyuris vermicularis, Enterobius vermicularis
German Madenwuermer, Enterobius vermicularis, Oxyuris vermicularis
Italian Ossiuri, Oxyuris vermicularis, Enterobius vermicularis
Portuguese Oxiures, Enterobius vermicularis, Oxyuris vermicularis
Spanish Oxiuros, Enterobius vermicularis (organismo), Oxiurus vermicularis, oxiuro, Enterobius vermicularis, Oxyuris vermicularis
Japanese 蟯虫症, ギョウチュウショウ
Czech Roupy, roup dětský
Hungarian Cérnagiliszták
Norwegian Enterobius vermicularis, Oxyuris vermicularis, Barnemark, Barneorm
Sources
Derived from the NIH UMLS (Unified Medical Language System)


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