Further Outpatient Care
Patients with pinworm infection must undergo follow-up examination to evaluate for reinfection after chemotherapy is completed. Although the first single examination may be negative for Enterobius eggs, a follow-up perianal swab is necessary if perianal itching or prickling pain persists.
Deterrence/Prevention
- Personal and group hygiene must be improved.
- Individuals must wash their hands before eating.
- At-risk individuals should bathe upon waking to help reduce the egg contamination.
- Discourage children from activities such as sucking their fingers and scratching bare anal areas.
- Treatment is much more effective if the child's family and classmates are treated at the same time.
- Washing sheets, clothes, and towels in a washing machine using regular laundry soap can eliminate pinworm eggs. However, eggs become noninfective after 2 weeks. Therefore, an emphasis on washing and environmental cleaning does not significantly improve the effectiveness of therapy.
Complications
- Pinworm infection does not cause severe morbidity unless ectopic infection occurs. This rare complication occurs in individuals with conditions that compromise the integrity of the bowel wall (eg, inflammatory bowel disease). Parasites migrate through the bowel wall and are found in extracolonic sites. Ectopic enterobiases have been described in various locations, including the vagina, salpinx, inguinal area, genital area, pelvic peritoneum, omentum, liver, and even the lungs.
- Some case reports have suggested that severe pinworm infection may be associated with an increased risk of appendicitis.[1]
- Scratching the itchy area may cause eczema or a bacterial infection around the rectum. In girls, pinworm infection can spread to the vagina and may cause a vaginal discharge.
Prognosis
- Eradicating pinworm in groups of institutionalized persons is difficult. Continuous follow-up examination is necessary.
- Therapy is much more effective if the child's family and classmates are treated at the same time.
Patient Education
- Focus on handwashing, especially before eating.
- Washing sheets, clothes, and towels in a washing machine using regular laundry soap can eliminate pinworm eggs. Eggs become noninfective after 2 weeks. Therefore, an emphasis on washing and environmental cleaning does not significantly improve the effectiveness of therapy.
- For excellent patient education resources, visit eMedicine's Parasites and Worms Center and Esophagus, Stomach, and Intestine Center. Also, see eMedicine's patient education articles, Pinworms and Anal Itching.
Ramezani MA, Dehghani MR. Relationship between Enterobius vermicularis and the incidence of acute appendicitis. Southeast Asian J Trop Med Public Health. Jan 2007;38(1):20-3. [Medline].
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].
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].
Burkhart CN, Burkhart CG. Assessment of frequency, transmission, and genitourinary complications of enterobiasis (pinworms). Int J Dermatol. Oct 2005;44(10):837-40. [Medline].
CDC. Parasitic disease information. Division of parasitic diseases. Pinworm Infection. Available at http://www.cdc.gov/NCIDOD/dpd/parasites/pinworm/factsht_pinworm.htm.
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].
Cho SY, Kang SY, Kim SI, et al. Effect of anthelmintics on the early stage of Enterobius vermicularis. Kisaengchunghak Chapchi. Jun 1985;23(1):7-17. [Medline].
Chong VH. Education and imaging. Gastrointestinal: enterobiasis. J Gastroenterol Hepatol. Jan 2009;24(1):168. [Medline]. [Full Text].
Gargano R, Di Legami R, Maresi E, et al. Chronic sialoadenitis caused by Enterobius vermicularis: case report. Acta Otorhinolaryngol Ital. Aug 2003;23(4):319-21. [Medline].
Hong ST, Cho SY, Seo BS, et al. Chemotherapeutic control of Enterobius vermicularis infection in orphanages. Kisaengchunghak Chapchi. Jun 1980;18(1):37-44. [Medline].
Isik B, Yilmaz M, Karadag N, et al. Appendiceal Enterobius vermicularis infestation in adults. Int Surg. Jul-Aug 2007;92(4):221-5. [Medline].
Kang S, Jeon HK, Eom KS, et al. Egg positive rate of Enterobius vermicularis among preschool children in Cheongju, Chungcheongbuk-do, Korea. Korean J Parasitol. Sep 2006;44(3):247-9. [Medline].
Park JH, Han ET, Kim WH, et al. A survey of Enterobius vermicularis infection among children on western and southern coastal islands of the Republic of Korea. Korean J Parasitol. Dec 2005;43(4):129-34. [Medline].
Ryue HS, Jung JW, Pai KS. An Epidemiological Study on Refractory Enterobiasis. Korean J Pediatr. Feb/2004;47(2):177-182.
Song HJ, Cho CH, Kim JS, et al. Prevalence and risk factors for enterobiasis among preschool children in a metropolitan city in Korea. Parasitol Res. Sep 2003;91(1):46-50. [Medline].
The Korean Society for Parasitology. Atlas of Medical Parasitology. Available at http://www.atlas.or.kr/.
Tornieporth NG, Disko R, Brandis A, et al. Ectopic enterobiasis: a case report and review. J Infect. Jan 1992;24(1):87-90. [Medline].
Welch NM. Recent insights into the childhood "social diseases"--gonorrhea, scabies, pediculosis, pinworms. Clin Pediatr (Phila). Apr 1978;17(4):318-22. [Medline].
Yang YS, Kim SW, Jung SH, et al. Chemotherapeutic trial to control enterobiasis in schoolchildren. Korean J Parasitol. Dec 1997;35(4):265-9. [Medline].
Yoon HJ, Choi YJ, Lee SU, et al. Enterobius vermicularis egg positive rate of pre-school children in Chunchon, Korea (1999). Korean J Parasitol. Dec 2000;38(4):279-81. [Medline].
Zahariou A, Karamouti M, Papaioannou P. Enterobius vermicularis in the male urinary tract: a case report. J Med Case Reports. Nov 14 2007;1:137. [Medline].
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