Enterobius vermicularis (pinworm)

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Key Points

  • Enterobius vermicularis
    • Characteristics
      • Also known as a pinworm
      • Type of nematode (roundworm) parasite
      • Most common intestinal worm in US
    • Transmission
      • Fecal-oral
        • Eggs get under fingernails when host scratches perianal region and are ingested
        • Auto-infection is common
        • School-aged children and daycare workers
    • Presentation: Enterobiasis
      • Anal pruritis
        • Usually more severe at night
          • May lead to difficulty sleeping
        • Worms live in the intestine (appendix and cecum)
        • Migrate out of anus at night to lay eggs in perianal region
    • Diagnosis
      • Scotch tape test
        • Placing a piece of tape to the anus may reveal eggs
      • Stool O&P not effective
        • Since eggs are rarely passed in stool
    • Treatment
      • Bendazoles
        • Mebendazole and albendazole are first-line
      • Oxantel/Pyrantel pamoate
        • Second-line agent; preferred in pregnant patients