Vermicularis Infestation Research Articles

Enterobius vermicularis (pinworm) infestation mimicking acute appendicitis in two children from Palestine: a case report

BackgroundPinworm, Enterobius vermicularis, is a common parasitic illness, particularly among children in Palestine. On rare occasions, it can cause serious consequences such as acute appendicitis, which can still present a challenging diagnosis especially in children.Case presentationThis report describes two cases (a 9 year old male and a 11 year old female, both Palestinian children from Hebron district) of acute appendicitis referred to Queen Alia Hebron Governmental Hospital in Palestine. The clinical examination revealed a lower abdominal pain, and they were diagnosed with appendicitis. The pathological examination after appendectomy showed the presence of eggs and pinworms. Anthelminthic medication was provided, and they were followed up for 6 weeks after the operation without any incidents.ConclusionThese cases highlight the importance of considering Enterobius vermicularis infestation in children with abdominal pain, as the parasites can mimic appendicitis. Prompt recognition and cautious laparoscopic appendectomy are crucial to prevent unnecessary surgery and peritoneal contamination, with the infestation being easily treatable with anthelmintic medication.

Management and Incidence of Enterobius vermicularis Infestation in Appendectomy Specimens: A Cross-Sectional Study of 6359 Appendectomies.

Background: The role of Enterobius vermicularis infestation in the context of appendicitis is largely overlooked, but Enterobius vermicularis is considered an unexpected and significant appendicectomy finding. The aim of this study was to investigate the frequency of Enterobius vermicularis findings in appendectomies and to evaluate the clinical and histopathologic features of patients with Enterobius vermicularis-associated acute appendicitis and those with appendiceal Enterobius vermicularis infestation. Methods: The medical records of all children who underwent an appendectomy in two large pediatric centers in Croatia between 1 January 2009 and 1 January 2024 were retrospectively reviewed. Of 6359 appendectomies, 61 (0.96%) children were diagnosed with Enterobius vermicularis on histopathology and included in further analysis. The groups were compared with regard to demographic characteristics, laboratory values, clinical features and histopathological findings. Results: The incidence of enterobiasis fluctuated slightly in the individual study years, but was constant overall. The median age of all patients was 11 years (IQR 8.5, 13), with females predominating (60.7%). Acute appendicitis was observed in 34% of the appendiceal species. The patients with Enterobius vermicularis infestation, without appendicitis, were younger (9 years (IQR 8, 13) vs. 12 years (IQR 10, 15); p = 0.020), had longer duration of symptoms (36 h (IQR, 12, 48) vs. 24 h (IQR, 12, 36); p = 0.034), lower body temperature (37 °C (IQR 36.8, 37.4) vs. 37.6 °C (IQR, 37, 38.6) p = 0.012), lower Appendicitis Inflammation Response (AIR) score (3 (IQR 2, 5) vs. 7 (IQR 5, 9.5) p < 0.001), lower incidence of rebound tenderness (57.1% vs. 20%; p = 0.003) and less frequent vomiting (12.5% vs. 47.6%; p = 0.004) compared to the patients with Enterobius vermicularis-associated acute appendicitis. Acute inflammatory markers in the laboratory showed significantly higher values in the group of patients with acute appendicitis: C-reactive protein (p = 0.009), White blood cells (p = 0.001) and neutrophils (p < 0.001). Eosinophilia was not found in any of the groups, although eosinophil counts were significantly higher in children who had Enterobius vermicularis infestation than in those with Enterobius vermicularis-related appendicitis (2.5% (IQR 0.9, 4.3) vs. 1.8% (IQR 0.7, 2.1); p = 0.040). Conclusions: Pediatric surgeons should consider Enterobius vermicularis infestation as a differential diagnosis when removing a vermiform appendix. Younger age, longer duration of symptoms, lower body temperature, lower AIR score, lower diameter of the appendix and normal laboratory inflammatory markers could predict Enterobius vermicularis infection in children presenting with right iliac fossa pain and avoid unnecessary appendectomy.

Enterobius vermicularis (Pinworm) Appendicitis: The Real Vermiform Appendix.

Enterobius vermicularis is the most common helminthic infection in the United States, infecting an estimated 40 million persons. A rare complication of E. vermicularis infestation is appendicitis. The diagnosis must be considered during pathologic examination to ensure appropriate treatment with anti-helminthic therapy.

Histopathological study of lesions of appendix

The human appendix is a supposedly funtionless organ, but can cause morbidity and mortality because it is likely to be infected. Acute Appendicitis being the most common surgical emergency. Appendicectomy specimens from suspected acute appendicitis often appear macroscopically normal but histological analysis reveal a more sinister underlying pathology.A three year study was performed to determine the incidence of various non-neoplastic and neoplastic lesions of appendix. To study the histopathology of various lesions of appendix.It is a retrospective study for a period of three years at Tertiary care hospital. The histopathological reports and clinical details were collected and slides were reviewed and evaluated. Special stains were used wherever required.The study included 1092 cases of lesions of appendix. The commonest lesion was chronic non-specific appendicitis (48.27%) followed by acute appendicitis with (47.80%). Other non neoplastic lesions found were fibrous obliteration of appendix (2.10%), chronic appendicitis with Enterobius vermicularis infestation (0.83), tuberculosis (0.18), xanthogranulomatous appendicitis (0.09%) and amoebic appendicitis (0.09%). Neoplastic lesions seen were low grade mucinous neoplasm (0.18) and serrated adenoma (0.09). Chronic non-specific appendicitis is the commonest appendiceal lesion. The various lesions of appendix clinically present as acute or chronic appendicitis but histology reveals the true nature of the lesion and hence remains the gold standard method.

Prevalence of and risk factors for Enterobius vermicularis infestation in preschool children, West Bank, Palestine, 2015.

Enterobius vermicularis (pinworm) infestation is a common condition that primarily affects children. The aim of this study was to assess the prevalence of and the risk factors for E. vermicularis infestation in preschool children in north West Bank. A cross-sectional study that included the six main governorates in north West Bank was carried out on a sample of 384 preschool children from 86 day-care centres. The perianal cellophane tape method was used to detect E. vermicularis infestation. Parents/guardians of participating children completed a questionnaire to collect information about: demographic characteristics; hygiene behaviour; socioeconomic status; history of previous infestation; and presence of symptoms. Risk factors for infestation were assessed using logistic regression analysis. Of the 384 children, 85 (22.1%) had E. vermicularis infestation. Age (P = 0.04), governorate (P = 0.01), residency (P = 0.03), number of household members (P < 0.001) and washing hands after toilet use (P = 0.01) were significantly associated with E. vermicularis infestation. In the logistic regression analysis, factors that increased the probability of infection were: living in villages (odds ratio (OR) 2.25; 95% confidence interval (CI): 1.01-5.00), living in a household with ≥ nine family members (OR 3.63; 95% CI: 1.42-9.26) and not washing hands after using the toilet (OR 2.4; 95% CI: 1.30-4.40). E. vermicularis is an important helminthic infestation among preschool children in Palestine. Efforts are needed to ensure the availability of treatment for infected children at primary care centres and to reinforce hygiene behaviour.

Incidental Acute Appendicitis due to Enterobius vermicularis

Simultaneous <em>Enterobius vermicularis</em> infection and appendicitis is rare. Nocturnal anal pruritus remains the most important clinical symptom of E. vermicularis infestation, a result of female pinworms laying eggs within the anal verge at night. Laparoscopic appendectomy is the definitive treatment for appendicitis, followed by either mebendazole or albendazole for complete pinworm eradication.

Study of the role of IQ in children with Enterobius vermicularis infestation compared to healthy children

<em><em>Enterobius vermicularis</em></em> has the widest geographic distribution among parasitic worms. This parasitic infestation is more common among children in population centers (nursery school, preschool).

Enterobius vermicularis in appendectomy specimens; Clinicopathological assessment: Cross sectional study

BackgroundThis study identifies the incidence of appendiceal Enterobius vermicularis (E.v) infestation in all the patients undergoing appendectomy and evaluates the relationship between E. v infestation of the appendix and the acute appendicitis. Methodology: All the routinely examined appendectomy specimens received in the pathology laboratory of a referral hospital over a three year period of time were reviewed for the existence of E. v. These cases were evaluated for clinico-laboratory characterization. ResultsOut of 1150 appendectomies for clinical acute appendicitis picture, 31 (2.7%) cases revealed E. v infestation. The age ranged from 6 to 42 years old but more than 80% of the E. v infected cases were children. Twenty four cases (77.4%) did not show any other appendiceal pathology, six cases showed lymphoid hyperplasia and only one case showed concomitant histological acute inflammatory process. ConclusionE. v infestation is an incidental finding during histopathology examination of appendectomy specimens for patients with clinical diagnosis of acute appendicitis, however there is no relation between the existence of E. v and occurrence of acute appendicitis which is the main indication for appendectomy, so further studies are recommended to reach out earlier diagnosis to eliminate the unnecessary surgical intervention. Also surgeons should consider E. v as a differential diagnosis when removing a normal looking appendix to take the necessary precautions for minimizing any chance of contamination and sending all the normal looking appendectomy specimens for histopathology examination.

Prevalence of Oxyuriasis and its Relationship With Eosinophilia in Children Aged 1 to 6 Years in Marand City, East Azerbaijan Province, Iran

Introduction: Enterobius vermicularis, commonly known as pinworm, is one of the most prevalent intestinal nematodes of humankind belonging to the Oxyuridae family. It is a small, white or transparent, threadlike roundworm. The length of the male worm is 2 to 3 mm and the female worm is 3 to 8 mm in length. This study was performed to determine the prevalence of E. vermicularis and its relationship with disease symptoms, allergic disease symptoms, and eosinophilia in children aged one to six years in Marand city of East Azerbaijan province, Iran. Methods: In this descriptive-analytical study, 200 children were studied using systematic random sampling. Data collection method was based on a questionnaire, peripheral blood smear, and Scotch tape test. In the designed questionnaire, children’s characteristics such as gender and age and parents’ characteristics including job and level of education were recorded. Peripheral blood smear slides were obtained from each child and examined for eosinophilia by a hematologist. Scotch test samples were prepared by parents after providing the necessary training on its sampling method and then examined in the laboratory for the presence of E. vermicularis eggs by a parasitologist. Results: In this study, 64 (32%) children were diagnosed with oxyuriasis. The prevalence of oxyuriasis was 36.5% in boys and 43.7% in girls. There was no significant relationship between oxyuriasis and its symptoms. Additionally, there was no significant relationship between oxyuriasis and allergic disease symptoms. Fourteen children had eosinophilia (7%), of which 9 (64%) were infected with E. vermicularis. There was a significant relationship between E. vermicularis infection and eosinophilia (P ˂ 0.05). Conclusion: According to the results of the study and the importance of the issue for the control and prevention of this disease, it is suggested that people should be provided with the necessary information about the life cycle, ways of transmission, and especially ways to prevent E. vermicularis infestation, and basic measures should be taken to improve the economic situation of the people of the region and to promote public and personal health through public education. Finally, medical treatment of patients and their families should be considered at the same time.

Enterobius vermicularis Infestation over the Anterior Abdominal Wall – a Rare Site

Enterobius vermicularis is an intestinal nematode. In humans, it is the most common intestinal parasite. Extraintestinal infestation with Enterobius vermicularis is a rare manifestation of the disease. However, it has been described that it can occur in anatomical sites where larvae may migrate such as the vagina, endometrium, fallopian tubes, and peritoneum. But the subcutaneous tissue of abdominal wall being infested in the absence of perforation of intestinal wall is an extremely rare site which is reported in only one case in the literature. We report a case of a 21-year-old male patient who was diagnosed with Enterobius vermicularis infestation over the anterior abdominal wall without perianal symptoms or infestation of gastrointestinal tract.

Acute appendicitis caused as a result of enterobius vermicularis infestation - A case report

Acute appendicitis caused as a result of enterobius vermicularis infestation - A case report

Enterobius vermicularis (pinworm) infestation in a child presenting with symptoms of acute appendicitis: a wriggly tale!

Acute appendicitis is the most common surgical emergency worldwide. However, it can still present a challenging diagnosis especially in the young, elderly and those individuals of reproductive age, thus encompassing...

Neonatal Worm Infestation: A Rare Entity

Worm infestation is very common in school going children especially in developing country but it is rarely seen in infancy or neonates. We present a case of Neonatal Enterobius vermicularis infestation manifesting as anemia and poor weight gain.

Enterobius vermicularis infestation of urinary tract leading to recurrent urinary tract infection.

Enterobius vermicularis infestation of urinary tract leading to recurrent urinary tract infection.

Enterobius vermicularis and its role in paediatric appendicitis: protection or predisposition?

E nterobius vermicularis is one of the most common parasitic infections of the gastrointestinal tract, and has been shown to infest up to 28% of children worldwide. The role of E . vermicularis in acute appendicitis has previously been questioned, with some studies identifying infection as a precursor for inflammation of the appendix, with others refuting such a link. A retrospective review was conducted of all appendices received for histological analysis at our unit from January 2002 to December 2011 (10-year period), removed in the course of acute appendicectomy in children aged 3 to 15 years. Appendices were categorized by degree of inflammation and infestation with E . vermicularis. Appendicectomy for clinical suspicion of acute appendicitis was performed in 2923 patients, 1694 (58%) male, median age 11.6 years. E . vermicularis was present in 4% of appendices; 25% of which showed concurrent acute inflammation. E . vermicularis infestation was more common in females (F : M 76% versus 24% of inflamed appendices and 66.7% versus 33.3% for non-inflamed appendices). European individuals showed higher representation in the E . vermicularis group than the total study population (79% versus 53% respectively). E . vermicularis was found to be more common in females and those of European descent. Seventy-seven percent of patients with E . vermicularis did not have concurrent acute inflammation of the appendix on histological examination. The question remains as to whether infestation is protective of inflammation or whether infestation causes appendiceal colic and subsequent appendicectomy of a non-inflamed appendix, thereby protective of the morbidity of acute appendicitis.

Is Enterobius vermicularis infestation associated with acute appendicitis?

Enterobius vermicularis might be seen in specimens of patients who underwent surgery due to acute appendicitis. There is still debate as to E. vermicularis infestation causes acute appendicitis. The primary aim of this study is to determine the incidence of E. vermicularis infestation, and the secondary aim is to determine the possible role of E. vermicularis in pathogenesis of appendicitis as well as the adequacy of demographic data and laboratory values in predicting infestation preoperatively. A retrospective investigation was conducted with all patients who underwent appendectomy due to acute appendicitis in a secondary care center. Patients with E. vermicularis were compared with 24 controls that underwent appendectomy during the same time period. Demographic data, preoperative white blood cell (WBC) count, eosinophil counts, and histopathological findings for both groups were analyzed and compared. Enterobius vermicularis was detected in the appendectomy materials in 9 of 1446 patients (0.62%). Histopathologically, only one of nine patients had acute appendicitis while the others were diagnosed with lymphoid hyperplasia. There were no statistically significant differences between the groups except WBC count. However, the WBC count was significantly (p<0.05) lower in the group which was detected E. vermicularis. Enterobius vermicularis is rarely associated with the histopathological findings of acute appendicitis. Also eosinophil count and elevation of white blood counts are inadequate for predicting preoperative E. vermicularis.

Incidental Enterobius Vermicularis infestation in surgically removed appendices with a clinical diagnosis of acute appendicitis: A retrospective analysis

Background: Appendiceal parasites can cause symptoms of appendicitis. Although the symptomatology imitates acute appendicitis clinically, the true nature of disease is diagnosed through histological examination. The aim of this study is to therefore determine the prevalence of E. Vermicularis in appendicectomy specimens to relate this to acute inflammation histologically.Materials &amp; Methods: Histological data on all appendectomy specimens with a clinical diagnosis of acute appendicitis were retrieved from the archives of department of pathology, B.P.K.I.H.S, over the period of five years (January 2004- December 2008) and was analyzed retrospectively.Results: There were a total of 1528 patients. M:F ratio being 1.2:1.Inflamed appendix constituted for 94.24% of all cases. There were a total of six (0.39%) appendicectomy specimens which showed presence of oxyuriasis appendix. Though all patients with oxyuriasis presented with appendicial colic only one (1) out of the six cases of oxyuriasis showed histologic evidence of inflammation. Conclusion: We conclude that enterobius does not frequently cause inflammation of appendix though it may clinically mimic acute appendicitis. Since it represents a disease curable without necessitating surgery, symptomatology awareness is stressed upon.Journal of Pathology of Nepal (2015) Vol. 5, 720-722

An evaluation of the relationship between Enterobius vermicularis infestation and acute appendicitis in a paediatric population – A retrospective cohort study

BackgroundEnterobius vermicularis is an often unexpected finding in appendectomy specimen, most commonly seen in paediatric cases. Predicting the presence of E. vermicularis in the setting of appendectomy is important to avoid unnecessary appendectomy and associated morbidity. We sought to identify the incidence of E. vermicularis in a paediatric population undergoing appendectomy for clinically suspected acute appendicitis and identify predictive factors for E. vermicularis. MethodsThis study was performed in an 800-bed University Teaching Hospital, in the Republic of Ireland. We identified all paediatric appendectomies performed at our institute from January to December 2012 using prospectively maintained operating theatre logbooks. In-hospital Histopathology database, medical notes and operative findings were reviewed for each patient and relevant data recorded. Statistical analysis was performed using IBM SPSS, version 21. ResultsIn total 182 paediatric appendectomies were performed during the year 2012 for clinically suspected acute appendicitis. Demographics included: Mean age 11.14 years (3–16), gender 1M: 1F. 58.8% of procedures were completed laparoscopically, 39% open and 2.2% were converted. The negative appendectomy rate was 22.5%. The annual incidence of E. vermicularis in acute appendicitis specimen from a paediatric cohort at our institute was 7% (1 in 14). In specimen containing E. vermicularis, 69% had no evidence of appendicitis and of those that had, no gangrene or perforation was seen. The presence of E. vermicularis in paediatric patients with RIF pain may be predicted by Eosinophilia (p = 0.016), normal WCC (p = 0.034) and normal Neutrophil count (p = 0.014). ConclusionsE. vermicularis is responsible for 7% of acute appendicitis. It is responsible for a significantly higher negative appendectomy rate which if predicted may avoid unnecessary appendectomy and associated morbidity.

Regular Deworming: A Missed Opportunity to Prevent Peritoneal Dialysis-Related Infections in Children.

Chronic peritoneal dialysis (PD) is a common dialysis treatment modality used to treat children with end-stage renal disease. Dialysis-related infections are the leading cause of technique failure. Enterobius vermicularis infestation indirectly increases the infection rate by causing pruritus around the anus, especially at night. We observed a significant decrease in the total infection rate (2.3 vs 5.4 per patient-year) following regular deworming over a 1-year study period. Regular deworming may be considered to prevent secondary bacterial infections in children on chronic PD.

Enterobiasis caused changes in the mucous and skin of female genital tract

The paper presents the changes in the skin of the external genitalia and perianal area, as well as in the mucous caused by enterobiasis. Enterobius vermicularis infestation has been identified in 60 % of patients with changes in the skin and mucous membranes. The influence of mature pinworms and their eggs on the vulva, causes a local reaction, which is accompanied by itching, discomfort, swelling, change in consistency and color of vaginal discharge. Only in 30 % of infected patients the complaint "night itch" was noted. Colposcopy changes of the vaginal mucosa and cervix have been detected in all women with enterobiasis.