eMedicine Specialties > Infectious Diseases > Parasitic Infections

Pinworm: Differential Diagnoses & Workup

Author: Sun Huh, MD, PhD, Chairman, Professor, Department of Parasitology, College of Medicine, Hallym University, Korea
Coauthor(s): Sooung Lee, PhD, Research Professor, Department of Environmental and Tropical Medicine, College of Medicine, Konkuk University, Korea
Contributor Information and Disclosures

Updated: Aug 11, 2008

Differential Diagnoses

Crohn Disease
Hidradenitis Suppurativa
Proctitis and Anusitis
Ulcerative Colitis

Other Problems to Be Considered

Occult fecal leakage
Anorectal fissure, fistula, sinus tract
Atopic eczema
Seborrheic dermatitis
Lichen planus
Candida infection
Tinea cruris
Dietary causes (eg, tomatoes, citrus fruit, chili pepper)
Psychogenic causes
Idiopathic pruritus

Workup

Laboratory Studies

  • Use a perianal cellophane swab or cellophane tape to detect eggs3 (see Image 2).
    • The adult female pinworm dies after ovideposition; therefore, egg detection is associated with 5-11% false-positive rate and a 70-95% false-negative rate.
    • One report found that a single cellophane-tape examination yielded a sensitivity of 50%, 3 examinations yielded a sensitivity of 90%, and 5 examinations yielded a sensitivity of 99%.
    • Repeated examinations 1-2 days later produce more accurate results.

Imaging Studies

  • Imaging studies are not necessary for diagnosis of pinworm infection.

Other Tests

  • Other tests are not necessary for diagnosis of pinworm infection.

Histologic Findings

Microscopic examination shows the elongated ovoid egg distinctly compressed laterally and flattened on one side. The egg measures 50-60 µm X 20-30 µm and contains larva.

More on Pinworm

Overview: Pinworm
Differential Diagnoses & Workup: Pinworm
Treatment & Medication: Pinworm
Follow-up: Pinworm
Multimedia: Pinworm
References
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References

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  2. Tsibouris P, Galeas T, Moussia M, et al. Two cases of eosinophilic gastroenteritis and malabsorption due to Enterobious vermicularis. Dig Dis Sci. Dec 2005;50(12):2389-92. [Medline].

  3. Cho SY, Kang SY. Significance Of Scotch-tape Anal Swab Technique In Diagnosis Of Enterobius Vermicularis Infection. Kisaengchunghak Chapchi. Dec 1975;13(2):102-114. [Medline].

  4. Burkhart CN, Burkhart CG. Assessment of frequency, transmission, and genitourinary complications of enterobiasis (pinworms). Int J Dermatol. Oct 2005;44(10):837-40. [Medline].

  5. CDC. Parasitic disease information. Division of parasitic diseases. Pinworm Infection. Available at http://www.cdc.gov/NCIDOD/dpd/parasites/pinworm/factsht_pinworm.htm.

  6. Chan OT, Lee EK, Hardman JM, et al. The cockroach as a host for Trichinella and Enterobius vermicularis: implications for public health. Hawaii Med J. Mar 2004;63(3):74-7. [Medline].

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Further Reading

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Keywords

pinworm, pinworm infection, Enterobius vermicularis, E vermicularis, seatworm infection, threadworm infection, enterobiasis, oxyuriasis, helminthic infection

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Contributor Information and Disclosures

Author

Sun Huh, MD, PhD, Chairman, Professor, Department of Parasitology, College of Medicine, Hallym University, Korea
Disclosure: Nothing to disclose.

Coauthor(s)

Sooung Lee, PhD, Research Professor, Department of Environmental and Tropical Medicine, College of Medicine, Konkuk University, Korea
Disclosure: Nothing to disclose.

Medical Editor

Mary Nettleman, MD, MS, Chair, Department of Medicine, Michigan State University
Mary Nettleman, MD, MS is a member of the following medical societies: American College of Physicians, American Federation for Medical Research, American Society for Microbiology, Central Society for Clinical Research, Infectious Diseases Society of America, and Society of General Internal Medicine
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Gordon L Woods, MD, Consulting Staff, Department of Internal Medicine, University Medical Center
Gordon L Woods, MD is a member of the following medical societies: Society of General Internal Medicine
Disclosure: Nothing to disclose.

CME Editor

Eleftherios Mylonakis, MD, Clinical and Research Fellow, Department of Internal Medicine, Division of Infectious Diseases, Massachusetts General Hospital
Eleftherios Mylonakis, MD is a member of the following medical societies: American Association for the Advancement of Science, American College of Physicians, American Society for Microbiology, and Infectious Diseases Society of America
Disclosure: Nothing to disclose.

Chief Editor

Burke A Cunha, MD, Professor of Medicine, State University of New York School of Medicine at Stony Brook; Chief, Infectious Disease Division, Winthrop-University Hospital
Burke A Cunha, MD is a member of the following medical societies: American College of Chest Physicians, American College of Physicians, and Infectious Diseases Society of America
Disclosure: Nothing to disclose.

 
 
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