ENTEROBIUS VERMICULARIS

Department of Medical Microbiology

University of Nairobi
 1.0 Introduction

 Intestinal nematode, found in the large intestines

 Also known as pinworm
 Worldwide distribution, more in temperate climates
 More common in overcrowding places
 Orphanages, boarding schools etc
 Children most affected – high prevalence & intensity
 Cause disease known as enterobiasis
 2.0 Morphology
 Adults
 Females 9-12 mm, Males 2-3 mm

 Thick lips (cervical alae)

 Eggs
 Planocovex in shape

 Transparent wall

 Embryonated
Adult, Enterobius
vermucularis
Egg in wet saline preparation Egg in Iodine stained
preparation
 3.0 Life cycle
 Adults mate in LI, females get out of anus, lay eggs
 Eggs passed embryonate within a few hours
 Itchiness of perineum, scratching, stick to fingers &
nails, ingested accidentally (self or others), reach SI,
hatch, larvae move to LI, attach to mucosa, adults
 May be transmitted through clothing, beddings, food
etc contaminated with eggs, dustborne by inhalation,
retroinfection
 Life cycle 4-6 weeks
Life cycle-2
 4.0 Clinical presentation
 Light infection mostly asymptomatic
 Clinical presentation includes
 Pruritus ani (scratching the anus) usually at night

 Sleep disturbance

 Irritability & lack of concentration in school

 Poor class performance

 Loss of appetite

 Complications include
 Appendicitis

 Salpingitis in females (rare)

 5.0 Diagnosis
 Microscopic identification of eggs must be done in
the morning, before defecation and washing by
 Adhesive scotch tape test - Press transparent
adhesive tape on the perianal skin & then
examining tape placed on a slide
 Anal swabs – Press a swab coated with adhesive
material on the perianal skin
 Camel hair brush

 Eggs occasionally found in stool, urine, vaginal

smears
 Adult worms may also be found in perianal area
Enterobius vermicularis eggs in a cellophane tape
 6.0 Treatment
 Mebendazole
 Albendazole
 Pyrantel Pamoate
* In institutional outbreaks treat all the household
members
 7.0 Prevention & Control
 Proper hygiene
 Daily bathing

 Frequent changing of clothes & beddings

 Keeping short nails etc,

 Avoiding overcrowding, opening of windows for

ventilation etc
 Health education
 Washing of hands before eating of a meal

 Treatment of infected persons with antihelminthes