Presentation
History
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Patients with enterobiasis are often asymptomatic. Worms may be incidentally discovered when they are seen in the perineal region.
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If patients are symptomatic, pruritus ani and pruritus vulvae are common presenting symptoms.
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Restlessness during sleep is noted by the parents of many patients.
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Enuresis may be a symptom in children with pinworms.
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Physical
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Patients often have excoriation or erythema of the perineum, vulvae, or both, but infestation can occur without these signs.
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Visual sighting of a worm by a reliable source (eg, a parent) is usually accepted as evidence of infestation and grounds for treatment.
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Worms can be found in stools or on the patient's perineum before bathing in the morning.
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Occasionally, the gravid female worm may aberrantly migrate into the female genitalia and produce vaginitis. [7] Incidental recovery at necropsy or surgery of small granulomatous lesions surrounding the worm, larvae, or eggs in the salpinx and peritoneum demonstrates the worm's ability to ascend the female genital tract.
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Abdominal pain may sometimes be severe and can mimic acute appendicitis. [8]
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Causes
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Enterobiasis is caused by the nematode E vermicularis.
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Because of the short incubation time until the ova are infectious, eggs that are deposited under the fingernails during scratching and then placed in the mouth may be a mode of reinfestation.
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