Enterobiasis overview: Difference between revisions

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Latest revision as of 21:35, 29 July 2020

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Furqan M M. M.B.B.S [2]

Overview

Enterobiasis is an infection commonly caused by Enterobius vermicularis (pinworm). It usually affects children and causes perianal pruritus, restlessness, and irritability. The diagnosis is made by physical examination and repeated scotch-tape tests. This infection is medically treated with two doses of either pyrantel pamoate, albendazole, or mebendazole. The transmission of enterobiasis can be prevented by treating all the household members of the infected person and improving personal and household hygienic conditions (e.g., frequent hand washing, changing clothes, and covering food).

Historical Perspective

Enterobius vermicularis eggs found in western Utah are carbon dated to 7837 BC. In 1983, Jean-Pierre Hugot isolated a new species Enterobius gregorii which is identical to Enterobius vermicularis.

Classification

There is no established classification system for enterobiasis, though it may be classified on the basis of the organisms causing it; Enterobius vermicularis and Enterobius gregorii.

Pathophysiology

Enterobius vermicularis is usually transmitted via the feco-oral route to the human host. It reproduces in the small intestine of humans only. The gravid female worm lays eggs in the perianal area usually at night and causes pruritus. In addition to the fingernail contamination, the infective eggs can be transmitted via the dust and fomites.

Causes

Enterobiasis is caused by pinworm. The pinworm (genus Enterobius), also known as threadworm (in the United Kingdom and Australia) or seatworm, is a parasitic worm. It is a nematode (roundworm) and a common intestinal parasite or helminth, especially in humans.^[1] The medical condition associated with pinworm infestation is known as enterobiasis^[2] (a type of helminthiasis) or less precisely as oxyuriasis in reference to the family Oxyuridae.^[3]

Differentiating (Disease name) from other Conditions

Enterobiasis must be differentiated from other causes of perianal pruritus and the nematode infections.

Epidemiology and Demographics

Enterobiasis is particularly common in children. Annually, around 200 million people are infected worldwide. The pinworm is the most common helminth (i.e., parasitic worm) infection in the United States and Western Europe.

Risk Factors

Common risk factors in the development of enterobiasis are young age, unhygienic practices, and close contact with infected person.

Screening

There is insufficient evidence to recommend routine screening for enterobiasis.

Natural History, Complications and Prognosis

If left untreated, patients with enterobiasis may progress to develop secondary skin infections. Common complications of enterobiasis include bacterial dermatitis, folliculitis, vulvovaginitis, and recurrent cystitis. Prognosis is generally excellent.

Diagnosis

History and Symptoms

The symptoms of enterobiasis may include painful itching around the anus, restless sleep, poor appetite, and failure to gain weight. When the infection is heavy, there can be a secondary bacterial infection due to the irritation and scratching of the anal area.

Physical Examination

Patients with enterobiasis usually appear restless. Physical examination of patients with enterobiasis is remarkable for skin excoriations as a result of scratching (secondary to perianal itch), perianal skin infections, and visualization of adult worms in the perianal area (usually at night).^[4]^[5]

Laboratory Findings

Diagnosis of enterobiasis is often made clinically by observing the female worm(s) in the peri-anal region, but can also be made using the "scotch-tape" test, in which the sticky side of a strip of cellophane tape is pressed against the peri-anal skin, then examined under a microscope for pinworm eggs.

Chest X Ray

There are no X-ray findings associated with enterobiasis.

Echocardiography or Ultrasound

There are no echocardiography or ultrasound findings associated with enterobiasis.

Other Imaging Findings

There are no other imaging findings associated with enterobiasis.

Treatment

Medical Therapy

The treatment of enterobiasis involves the administration of such antiparasitic drugs as either mebendazole (Vermox), albendazole, piperazine (Antepar), or pyrantel pamoate (Combatrin, Povan). A repeat dose is recommended two weeks after the initial treatment. More than one household member is likely to be infected, so the entire household is often treated.

Surgery

Surgical intervention is not recommended for the management of enterobiasis.

Primary Prevention

Effective measures for the primary prevention of enterobiasis include treating family members, frequent handwashing, improving personal and household hygienic condition.

Secondary Prevention

The primary and secondary prevention strategies for enterobiasis are the same.

References

↑ Encyclopædia Britannica.
↑ Merriam-Webster: Enterobiasis
↑ Merriam-Webster: Oxyuriasis
↑ Cook GC (1994). "Enterobius vermicularis infection". Gut. 35 (9): 1159–62. PMC 1375686. PMID 7959218.
↑ Caldwell JP (1982). "Pinworms (enterobius vermicularis)". Can Fam Physician. 28: 306–9. PMC 2306321. PMID 21286054.

Template:WH Template:WS

[britannica-1] Encyclopædia Britannica.

[mw_enterobiasis-2] Merriam-Webster: Enterobiasis

[mw_oxyuriasis-3] Merriam-Webster: Oxyuriasis

[pmid7959218-4] Cook GC (1994). "Enterobius vermicularis infection". Gut. 35 (9): 1159–62. PMC 1375686. PMID 7959218.

[pmid21286054-5] Caldwell JP (1982). "Pinworms (enterobius vermicularis)". Can Fam Physician. 28: 306–9. PMC 2306321. PMID 21286054.

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[5]

@@ Line 1: / Line 1: @@
 __NOTOC__
-{{Pinworm}}
+{{Enterobiasis}}
-{{CMG}}
+{{CMG}}; {{AE}} {{MMF}}
 ==Overview==
-A pinworm is a small, thin, white roundworm ([[nematode]]) called Enterobius vermicularis that sometimes lives in the colon and rectum of humans. Pinworms are about the length of a staple. While an infected person   sleeps, female pinworms leave the intestine through the anus and deposit their eggs on the surrounding skin.
+Enterobiasis is an infection commonly caused by ''[[Enterobius vermicularis]]'' ([[pinworm]]). It usually affects children and causes perianal pruritus, restlessness, and irritability. The diagnosis is made by physical examination and repeated scotch-tape tests. This infection is medically treated with two doses of either [[pyrantel pamoate]], [[albendazole]], or [[mebendazole]]. The transmission of enterobiasis can be prevented by treating all the household members of the infected person and improving personal and household hygienic conditions (e.g., frequent hand washing, changing clothes, and covering food).
-The '''pinworm''' (Genus '''''Enterobius''''') is a [[parasitic]] [[roundworm]] of the phylum [[Nematoda]]. '''Enterobiasis''' is the medical condition of being [[infection|infected]] with [[pinworm]]s (''[[Enterobius vermicularis]]''). It may be referred to, less precisely, as '''oxyuriasis''', in reference to the [[Family (biology)|family]] ''Oxyuridae'', which contains the [[genus]] Enterobiasis.
+==Historical Perspective==
+''[[Enterobius vermicularis]]'' eggs found in western Utah are carbon dated to 7837 BC. In 1983, Jean-Pierre Hugot isolated a new species ''[[Enterobius gregorii]]'' which is identical to ''[[Enterobius vermicularis]]''.
+==Classification==
+There is no established classification system for enterobiasis, though it may be classified on the basis of the organisms causing it; ''[[Enterobius vermicularis]]'' and ''[[Enterobius gregorii]]''.
+==Pathophysiology==
+''[[Enterobius vermicularis]]'' is usually transmitted via the feco-oral route to the human host. It reproduces in the small intestine of humans only. The gravid female worm lays eggs in the perianal area usually at night and causes pruritus. In addition to the fingernail contamination, the infective eggs can be transmitted via the dust and fomites.
 ==Causes==
-The human pinworm ''[[Enterobius vermicularis]]'' and the more recently discovered ''[[Enterobius gregorii]]'' causes enterobiasis.
+[[Enterobiasis]] is caused by pinworm. The '''pinworm''' ([[genus]] '''''Enterobius'''''), also known as '''threadworm''' (in the United Kingdom and Australia) or '''seatworm''', is a [[parasitic worm]].  It is a [[nematode]] (roundworm) and a common [[intestinal parasite]] or [[helminth]], especially in humans.<ref name="britannica">[[#britannica|Encyclopædia Britannica]].</ref> The medical condition associated with pinworm infestation is known as [[enterobiasis]]<ref name="mw_enterobiasis">[[#mw|Merriam-Webster: Enterobiasis]]</ref> (a type of [[helminthiasis]]) or less precisely as oxyuriasis in reference to the [[family (biology)|family]] [[Oxyuridae]].<ref name="mw_oxyuriasis">[[#mw oxyuriasis|Merriam-Webster: Oxyuriasis]]</ref>
+==Differentiating (Disease name) from other Conditions==
+[[Enterobiasis]] must be differentiated from other causes of perianal pruritus and the [[nematode]] infections.
 ==Epidemiology and Demographics==
-Pinworms are particularly common in children. The prevalence of pinworms is not associated with gender, race, social class, or culture. The pinworm has a worldwide distribution, and is the most common [[helminth]] (i.e., parasitic worm) infection in the United States and Western Europe.
+Enterobiasis is particularly common in children. Annually, around 200 million people are infected worldwide. The pinworm is the most common [[helminth]] (i.e., parasitic worm) infection in the United States and Western Europe.
 ==Risk Factors==
-Children are at increased risk of having pinworm infection. Because it spreads from host to host through [[contamination]], pinworms are common among people living in close contact, and tends to occur in all people within a household. Finger sucking has been shown to increase both incidence and relapse rates, and nail biting has been similarly associated.
+Common risk factors in the development of enterobiasis are young age, unhygienic practices, and close contact with infected person.
+==Screening==
+There is insufficient evidence to recommend routine screening for enterobiasis.
+==Natural History, Complications and Prognosis==
+If left untreated, patients with enterobiasis may progress to develop secondary skin infections. Common complications of enterobiasis include bacterial [[dermatitis]], [[folliculitis]], [[vulvovaginitis]], and recurrent [[cystitis]]. Prognosis is generally excellent.
 ==Diagnosis==
 ===History and Symptoms===
-The symptoms may include painful [[itching]] around the [[anus]], restless [[sleep]], poor [[appetite]], and failure to gain weight.
+The symptoms of enterobiasis may include painful itching around the anus, restless sleep, [[poor appetite]], and failure to gain weight. When the infection is heavy, there can be a secondary bacterial infection due to the [[irritation]] and scratching of the anal area.
+===Physical Examination===
+Patients with enterobiasis usually appear restless. Physical examination of patients with enterobiasis is remarkable for [[Excoriation|skin excoriations]] as a result of scratching (secondary to perianal itch), perianal skin infections, and visualization of adult worms in the perianal area (usually at night).<ref name="pmid7959218">{{cite journal |vauthors=Cook GC |title=Enterobius vermicularis infection |journal=Gut |volume=35 |issue=9 |pages=1159–62 |year=1994 |pmid=7959218 |pmc=1375686 |doi= |url=}}</ref><ref name="pmid21286054">{{cite journal |vauthors=Caldwell JP |title=Pinworms (enterobius vermicularis) |journal=Can Fam Physician |volume=28 |issue= |pages=306–9 |year=1982 |pmid=21286054 |pmc=2306321 |doi= |url=}}</ref>
 ===Laboratory Findings===
-Diagnosis is often made clinically by observing the female worm (or many worms) in the peri-anal region, but can also be made using the [["scotch-tape" test]], in which the sticky side of a strip of [[cellophane]] tape is pressed against the peri-anal skin, then examined under a microscope for pinworm eggs.
+Diagnosis of enterobiasis is often made clinically by observing the female worm(s) in the peri-anal region, but can also be made using the [["scotch-tape" test]], in which the sticky side of a strip of [[cellophane]] tape is pressed against the peri-anal skin, then examined under a microscope for pinworm eggs.
+===Chest X Ray===
+There are no X-ray findings associated with enterobiasis.
+===Echocardiography or Ultrasound===
+There are no echocardiography or ultrasound findings associated with enterobiasis.
+===Other Imaging Findings===
+There are no other imaging findings associated with enterobiasis.
 ==Treatment==
 ===Medical Therapy===
-The condition can be treated with [[mebendazole]] (Vermox), [[albendazole]], [[piperazine]] (Antepar), or mostly commonly [[pyrantel pamoate]] (Combatrin, Povan). Taking a second dose of medication two weeks after the first will usually kill any pinworms that might have hatched in the meantime, before they are able to produce new eggs. More than one household member is likely to be infected, so the entire household is often treated.
+The treatment of enterobiasis involves the administration of such antiparasitic drugs as either [[mebendazole]] (Vermox), [[albendazole]], [[piperazine]] (Antepar), or [[pyrantel pamoate]] (Combatrin, Povan). A repeat dose is recommended two weeks after the initial treatment. More than one household member is likely to be infected, so the entire household is often treated.
+===Surgery===
+Surgical intervention is not recommended for the management of enterobiasis.
+===Primary Prevention===
+Effective measures for the primary prevention of enterobiasis include treating family members, frequent handwashing, improving personal and household hygienic condition.
 ===Secondary Prevention===
-Great care should be taken to shower daily, and wash hands before every meal to avoid re-infection. All infected materials (pajamas, bedclothes, and underwear) should be washed with soap and hot water daily. Avoid scratching the infected area around the anus. This can contaminate your fingers and everything else that you touch afterwards. Keep your hands and fingers away from your nose and mouth unless they are freshly washed. Carry out these measures while family members are being treated for pinworms.
+The primary and secondary prevention strategies for enterobiasis are the same.
 ==References==
 {{reflist|2}}
+{{WH}}
+{{WS}}
 [[Category:Disease]]
 [[Category:Parasites]]
 [[Category:Nematodes]]
 [[Category:Proctology]]
+[[Category:Pediatrics]]
+[[Category:Emergency medicine]]
+[[Category:Up-To-Date]]
 [[Category:Infectious disease]]
-[[Category:Pediatrics]]
+[[Category:Gastroenterology]]
-{{WH}}
-{{WS}}