PINWORM INFECTIONS

ENTEROBIASIS = OXYURIASIS

Etiology

• Enterobius vermicularis (Oxyuris vermicularis)• Small roundworm which can complete its life

cycle without an alternate host. • Greatest geographic distribution of any human

worm parasite worldwide.• Easily transmitted to other people by bedclothes,

by debris under fingernails of those ho scratch the itchy area around anus, and even inhalation of airborne eggs.

Patophysiology/Life cycleIngested eggs hatch in

small intestine and released larvae that

mature and reproduce in small intestine

Matured larvae go to caecum

Adult worm go as far as to rectum until reach the

skin of anal region

Inhalation/contact with infective eggs

Female worm will leave egg in the fold of skin surrounding anus (due to aerobic and low temperature)

The eggs become

infective within 2 to 4 hours

1 cycle : 1-6 weeks

Clinical Manifestations• Pruritus (itchy): The most common symptoms, especially

during the night (the intensities vary from light itchy to intractable acute pain)

• Another correlated symptoms: - Imsonia due to discomfort and itchy - Irritable- Weakness-Anorexia- Loss of weight

• Infection with large numbers of worms can cause the rectum to protrude from the body.

Diagnostic

• Presence of eggs around the anus; at night or right after the host awakens

• The pinworms can be picked up with the sticky side of transparent cellophane tape.

• The sticky part of cellophane tape is placed on an object glass and observed under microscope by low magnification.

• If one member of a family has pinworms, all are presumed infected and need to be treat.

Treatment• Pyrantel Pamoate (Combantrin)

- single dose 10mg/kg/day; DO NOT exceed than 1 gram• Mebendazole

- single dose 100mg• Piperazine citrate

- 65mg/kg/day, maximum dose 2g/day; given by single dose every day for 6 days.

• Pyrivinium Pamoate- 5mg/kg

• Stilbazium iodide- single dose 10mg/kg

• Albendazole- single dose 400mg (very affective)

Prognosis and Prevention

• The prognosis is good and usually harmless especially with prompt and proper treatment.

• Bed linens, clothing, and towels should be washed and the house thoroughly cleaned at the time of treatment.

• The treatment and cleaning are repeated in 10 days.

• In the absence of re-infection, the infection is self-limiting and will cease without treatment.