Pinworm infection
Pinworm infection | |
---|---|
Other names | Enterobiasis, oxyuriasis pyrantel pamoate, or albendazole[4] |
Prognosis | Non-serious[5] |
Frequency | Common[1][5] |
Pinworm infection (threadworm infection in the UK), also known as enterobiasis, is a
The disease is spread between people by pinworm eggs.[1] The eggs initially occur around the anus and can survive for up to three weeks in the environment.[1] They may be swallowed following contamination of the hands, food, or other articles.[1] Those at risk are those who go to school, live in a health care institution or prison, or take care of people who are infected.[1] Other animals do not spread the disease.[1] Diagnosis is by seeing the worms which are about one centimetre long or the eggs under a microscope.[1][6]
Treatment is typically with two doses of the medications
Pinworm infections commonly occur in all parts of the world.[1][5] They are the most common type of worm infection in Western Europe, Northern Europe and the United States.[5] School-aged children are the most commonly infected.[1] In the United States about 20% of children will develop pinworm at some point.[3] Infection rates among high-risk groups may be as high as 50%.[2] It is not considered a serious disease.[5] Pinworms are believed to have affected humans throughout history.[7]
Signs and symptoms
One-third of individuals with pinworm infection are totally asymptomatic.[8] The main symptoms are itching in and around the anus and perineum.[8][9][10] The itching occurs mainly during the night,[9][11] and is caused by the female pinworms migrating to lay eggs around the anus.[12][10] Both the migrating females and the clumps of eggs are irritating, as well as the sticky substance that is produced by the worms when the eggs are laid.[11][13] The intensity of the itching varies, and it can be described as tickling, crawling sensations, or even acute pain.[14] The itching leads to continuously scratching the area around the anus, which can further result in tearing of the skin and complications such as secondary bacterial infections, including bacterial skin inflammation, and hair follicle inflammation.[9][10][14] General symptoms are trouble sleeping, and restlessness.[9] A considerable proportion of children experience loss of appetite, weight loss, irritability, emotional instability, and bed wetting.[9]
Pinworms cannot damage the skin,[15] and they do not normally migrate through tissues.[10] However, they may move onto the vulva and into the vagina, from there moving to the external orifice of the uterus, and onwards to the uterine cavity, fallopian tubes, ovaries, and peritoneal cavity.[15] This can cause inflammation of the vulva and vagina.[9][10] This causes vaginal discharge and itchiness of the vulva.[9] The pinworms can also enter the urethra, and presumably, they carry intestinal bacteria with them.[15] According to Gutierrez (2000), a statistically significant correlation between pinworm infection and urinary tract infections has been shown;[15] however, Burkhart & Burkhart (2005) maintain that the incidence of pinworms as a cause of urinary tract infections remains unknown.[8] One report indicated that 36% of young girls with a urinary tract infection also had pinworms.[8] Painful urination has been associated with pinworm infection.[8]
The relationship between pinworm infestation and appendicitis has been researched, but there is a lack of clear consensus on the matter: While Gutiérrez maintains that there exists a consensus that pinworms do not produce the inflammatory reaction,[16] Cook (1994) states that it is controversial whether pinworms are causatively related to acute appendicitis,[14] and Burkhart & Burkhart (2004) state that pinworm infection causes symptoms of appendicitis to surface.[8]
Cause
The cause of a pinworm infection is the worm
Spread
Pinworm infection spreads through human-to-human
After the eggs have been initially deposited near the anus, they are readily transmitted to other surfaces through
Life cycle
The life cycle begins with eggs being
Diagnosis
Diagnosis relies on finding the eggs or the adult pinworms.[19] Individual eggs are invisible to the naked eye, but they can be seen using a low-power microscope.[21] On the other hand, the light-yellowish thread-like adult pinworms are clearly visually detectable, usually during the night when they move near the anus, or on toilet paper.[8][14][21] Shining a flashlight on the infected individual's anus about one hour after they fall asleep is one form of detection and may show worms crawling out of the anus.[22] Another form of detection is the use of transparent adhesive tape (e.g. Scotch Tape) applied on the anal area which will pick up deposited eggs, and diagnosis can be made by examining the tape with a microscope.[16][21] This test is most successful if done every morning for several days, because the females do not lay eggs every day, and the number of eggs varies.[21] A third method of diagnosis is examining a sample from under their fingernails under a microscope as itching around the anal area is common and therefore they may have collected some eggs under their nails as a result.[23]
Pinworms do not lay eggs in the
Prevention
Pinworm infection cannot be totally prevented under most circumstances.
Preventive action revolves around
The main measures are keeping fingernails short, and washing and scrubbing hands and fingers carefully, especially after defecation and before meals.[26][27] Showering every morning is also highly recommended to wash off any eggs that may be still lying on the skin.[28] Under ideal conditions, bed covers, sleeping garments, and hand towels should be changed daily[26] and clothes and linens should be washed in hot water and then be placed in a hot dryer in order to kill off any eggs.[28] Children can wear gloves while asleep, and the bedroom floor should be kept clean.[26] Regular disinfection of kitchen and bathroom surfaces will help to prevent spread as well.[29] Food should be covered to limit contamination with dust-borne parasite eggs.[26] It is not recommended to shake clothes and bed linen as the eggs may detach and spread[26] or to share clothes and towels. Nail biting and sucking on fingers is also discouraged.
Treatment
Medication is the primary treatment for pinworm infection.[26] However, reinfection is frequent regardless of the medication used.[8] Total elimination of the parasite in a household may require repeated doses of medication for up to a year or more.[9] Because the drugs kill the adult pinworms, but not the eggs, the first retreatment is recommended in two weeks.[21] Also, if one household member spreads the eggs to another, it will be a matter of two or three weeks before those eggs become adult worms and thus amenable to treatment.[27] Asymptomatic infections, often in small children, can serve as reservoirs of infection, and therefore the entire household should be treated regardless of whether or not symptoms are present.[9][26]
The
Treatment in pregnancy and breastfeeding
The available data on mebendazole, albendazole, and pyrantel pamoate use in pregnancy is limited and they are all assigned to pregnancy category level C. Treatment of a pinworm infection during pregnancy is only recommended for patients with significant symptoms that may be causing adverse effects to the pregnant woman such as loss of sleep and weight loss.[30][31] Pyrantel pamoate is the treatment of choice in pregnancy but should be used only after consultation with a health care practitioner rather than self-treatment.[30] Treatment should be avoided in the first trimester, and if possible done in the third trimester.[32][31] If the pregnant woman is asymptomatic, then they should be treated after the baby is delivered.[citation needed]
Mebendazole has less than 10% of the oral dose absorbed into systemic circulation with a clinically insignificant amount of drug excreted in breastmilk, and therefore treatment should not be withheld during breastfeeding.[31] There is limited data on the use of pyrantel pamoate and albendazole in breastfeeding but WHO also classifies them as compatible with breastfeeding. This is due to the drugs acting mainly in the intestinal system of the mother with only a very small amount of drug being absorbed into the systemic circulation.[31][33]
Epidemiology
Pinworm infection occurs worldwide,
History
The earliest known instance of pinworms is evidenced by pinworm eggs found in
Garlic has been used as a treatment in the ancient cultures of China, India, Egypt, and Greece.[36] Hippocrates mentioned garlic as a remedy against intestinal parasites.[37] German botanist Adam Lonicer also recommended garlic against parasitic worms.[38]
References
- ^ a b c d e f g h i j k l m n o p q r s "Pinworm Infection FAQs". CDC. 10 January 2013. Archived from the original on 15 October 2016. Retrieved 16 October 2016.
- ^ a b c "Epidemiology & Risk Factors". CDC. 10 January 2013. Archived from the original on 18 October 2016. Retrieved 16 October 2016.
- ^ PMID 19412003.
- ^ a b "Treatment". CDC. 23 September 2016. Archived from the original on 18 October 2016. Retrieved 16 October 2016.
- ^ ISBN 9781118441176. Archivedfrom the original on 5 November 2017.
- ^ "Biology". CDC. 10 January 2013. Archived from the original on 18 October 2016. Retrieved 16 October 2016.
- ISBN 9781136110368. Archivedfrom the original on 5 November 2017.
- ^ a b c d e f g h i j Burkhart & burkhart 2005, p. 838
- ^ a b c d e f g h i j k l m n o p q Cook et al. 2009, p. 1516
- ^ a b c d e f g h i Gutiérrez 2005, p. 355.
- ^ a b c d e f g h i j k l Caldwell 1982, p. 307.
- ^ a b c d e f g h i j k l m n o Cook 1994, p. 1159
- PMID 2011634.
- ^ a b c d e f g h Cook 1994, p. 1160
- ^ a b c d Gutiérrez 2005, p. 356.
- ^ a b Gutiérrez 2005, p. 363.
- ^ Gutiérrez 2005, p. 354.
- ^ a b c d e f g h i j k l m n o p q r s Burkhart & burkhart 2005, p. 837
- ^ a b c d e f g h i j k l m Garcia 1999, p. 246
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- ^ a b c d e f g h i Caldwell 1982, p. 308.
- ^ Health Canada (17 May 1996). "Anthelmintics". www.canada.ca. Retrieved 23 November 2021.
- ^ CDC-Centers for Disease Control and Prevention (19 April 2019). "CDC - Enterobiasis - Diagnosis". www.cdc.gov. Retrieved 23 November 2021.
- ^ dpdx 2009
- ^ Garcia 1999, p. 247
- ^ a b c d e f g h i j k l m n o Cook 1994, p. 1161
- ^ a b c d Caldwell 1982, p. 309.
- ^ a b CDC-Centers for Disease Control and Prevention (18 December 2020). "CDC - Enterobiasis - Prevention & Control". www.cdc.gov. Retrieved 23 November 2021.
- ^ "Threadworms". nhs.uk. 8 January 2018. Retrieved 23 November 2021.
- ^ PMID 30725659, retrieved 30 November 2021
- ^ a b c d CDC-Centers for Disease Control and Prevention (26 August 2019). "CDC - Enterobiasis - Resources for Health Professionals". www.cdc.gov. Retrieved 30 November 2021.
- PMID 7959218.
- hdl:10665/62435. Retrieved 24 November 2023.
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- ^ "Fact sheets: neglected tropical diseases". World Health Organization. WHO Media Centre. Archived from the original on 7 December 2014. Retrieved 6 December 2014.
- PMID 22228949.
- ^ Tucakov J. Beograd: Naucna knjiga; 1948. Farmakognozija; pp. 278–80.
- ^ 3. Tucakov J. Beograd: Kultura; 1971. Lecenje biljem - fitoterapija; pp. 180–90.
- References
- Hasegawa H, Ikeda Y, Fujisaki A, et al. (December 2005). "Morphology of chimpanzee pinworms, Enterobius (Enterobius) anthropopitheci (Gedoelst, 1916) (Nematoda: Oxyuridae), collected from chimpanzees, Pan troglodytes, on Rubondo Island, Tanzania". The Journal of Parasitology. 91 (6): 1314–7. S2CID 32110983.
- "Pinworm". Encyclopædia Britannica. Retrieved 8 April 2009.
- "Enterobiasis". Merriam-Webster's Medical Dictionary. Merriam-Webster. Retrieved 8 April 2009.
- "Oxyuriasis". Merriam-Webster's Medical Dictionary. Merriam-Webster. Retrieved 8 April 2009.
- Totkova A, Klobusicky M, Holkova R, Valent M (2003). "Enterobius gregorii—reality or fiction?" (PDF). Bratislavské Lekárske Listy. 104 (3): 130–133. PMID 12940699.
- "Enterobius". NCBI taxonomy database. National Center for Biotechnology Information, U.S. National Library of Medicine. 2009. Retrieved 8 April 2009.
- "Enterobiasis". DPDx. Division of Parasitic Diseases, Centers for Disease Control and Prevention. Archived from the original on 27 November 2013. Retrieved 8 April 2009.
- Nakano T, Okamoto M, Ikeda Y, Hasegawa H (December 2006). "Mitochondrial cytochrome c oxidase subunit 1 gene and nuclear rDNA regions of Enterobius vermicularis parasitic in captive chimpanzees with special reference to its relationship with pinworms in humans". Parasitology Research. 100 (1): 51–7. S2CID 32762371.
- Hugot JP (1983). "Enterobius gregorii (Oxyuridae, Nematoda), a new human parasite". Annales de Parasitologie Humaine et Comparée (in French). 58 (4): 403–4. PMID 6416131.
- Hasegawa H, Takao Y, Nakao M, Fukuma T, Tsuruta O, Ide K (February 1998). "Is Enterobius gregorii Hugot, 1983 (Nematoda: Oxyuridae) a distinct species?". Journal of Parasitology. 84 (1): 131–4. PMID 9488350.
- Gutiérrez, Yezid (2000). Diagnostic pathology of parasitic infections with clinical correlations (Second ed.). Oxford University Press. pp. 354–366. ISBN 0-19-512143-0. Retrieved 21 August 2009.
- Cook, Gordon C; ISBN 978-1-4160-4470-3. Retrieved 18 November 2009.
- "B80: Enterobiasis". International Statistical Classification of Diseases and Related Health Problems (ICD) 10th Revision. World Health Organization. 2007. Retrieved 5 December 2009.
- Cook GC (September 1994). "Enterobius vermicularis infection". Gut. 35 (9): 1159–62. PMID 7959218.
- Garcia, Lynne Shore (2009). Practical guide to diagnostic parasitology. American Society for Microbiology. pp. 246–247. ISBN 978-1-55581-154-9. Retrieved 5 December 2009.
- Burkhart CN, Burkhart CG (October 2005). "Assessment of frequency, transmission, and genitourinary complications of enterobiasis (pinworms)". International Journal of Dermatology. 44 (10): 837–40. S2CID 3193432.
- Caldwell JP (February 1982). "Pinworms (Enterobius vermicularis)". Canadian Family Physician. 28: 306–9. PMID 21286054.
- Vanderkooi M (2000). Village Medical Manual (5th ed.).
External links
- Brown MD (March 2006). "Images in clinical medicine. Enterobius vermicularis". The New England Journal of Medicine. 354 (13): e12. PMID 16571876.