ENTEROBIASIS

LEARNING OBJECTIVES
• a) Define Helminthiasis
• b) Explain risk factors/aetiology of Helminthiasis
• c) Explain clinical features and complications of Helminthiasis
• d) Perform clinical assessment for a patient with Helminthiasis
• e) Establish provisional and differential diagnoses
• f)Determine appropriate investigations to be performed to
patients with Helminthiasis
• g) Treat, conduct follow up and refer patients with
Helminthiasis as appropriate
• h) Provide preventive measures to patients with Helminthiasis
INTRO
• Pinworm infection, also called enterobiasis, is
caused by Enterobius vermicularis, a white slender
nematode with a pointed tail.

• In humans, they reside in the cecum, appendix, and

ascending colon.

• Female pinworms are 8-13 mm long, and males are

2-5 mm long.
CONT
• Enterobius vermicularis is a nematode worm
commonly known as pinworm.

• This because it has sharp & pointed posterior

end(like pin), or may be also due to pinpricks
sensation experienced by infected people

• Causing the disease known as Enterobiasis.

 Development of Entrobius eggs
• 1- E.vermicularis lay the eggs in the perianal skin.

• 2-Eggs are single celled when laid by the worms

• 3-After 4-6 hours they develop into larvated eggs

(infective stage)
• 4-The larvated eggs after ingestion by man they
develop into worms
How man become infected?
• Human becomes infected by ingestion of infective eggs
(contain larva)
• The larvae hatch in the small intestine

• Migrate to the large intestine

• Where they develop to adults (male & females)

• After 1 month the females become gravid

• The worm do not lay eggs in the intestinal lumen

• They lay eggs in perianal skin (skin around the anus)

 Cont…
• The worms migrates out the
colon and lays eggs around
the anus at usually night.

• Each worm lay about 10,000-

11,000 eggs

• The eggs can spread every

where and become infective
in 4 to 6 hours 10
Cont…
• Pinworm eggs can survive for up to two weeks on
clothing, bedding, food, and other surfaces.

• Ready to infect other people.

Types of infection occur in
entrobiasis
• 1- Infection Occur when healthy person ingest the
infective eggs from enviroment

• 2-Re- infection (self infection) A person can re-infect

themselves from their own( by ingestion of infective
eggs )

• 3-Retro-infection: This occur when eggs mature and

larvae hatch in anal area, this larva can migrate back to
the large intestine through the anus, where they grow into
mature worms. (larvae are the infective stages)
Presentation
• The most common clinical manifestation of a pinworm
infection is

• Night itch in anal region because worms lay eggs nocturnal

• Irritation of the anal area due to scratching

• Secondary bacterial infection

• Teeth grinding during sleeping

• Insomnia
Cont…..
• Other symptoms include irritability and, in females,
vaginal itching.
Differential Diagnoses

• Proctitis and Anusitis

Complications:
• Appendicitis: when worms invade the appendix

• Vaginitis: found in female patient due to invasion of

vagina by hatched larva from anal area 20
Laboratory Diagnosis
• 1- what is /are suitable sample/s?

• 2- what is are suitable diagnostic test/s or

technique/s?

• 3- what is/are the diagnostic stage/s?

Cont…
TREATMENT
• Treatment Several medications used for the
treatment of pinworm are
• Mebendazole
• Pyrantel pamoate
• Albendazole

• All three of these drugs are to be given in single

dose and then repeated 2 weeks later.

• Prognosis The prognosis is good

Prevention & control
• Washing hands with soap & water (after using
toilet, Before eat)

• Trimming nails regularly & avoid biting the nails

• Avoid scratching anal area.
• Showering every morning and washing the anal
area( to remove the eggs)

• Do not co-path with infected people

• Cleansing bathroom & toilet

• Washing cloth and bed linens with hot water, to kill

the eggs.
CONT….
• Ironing, or expose them to sunlight for 24 hours to
kill the eggs

• Treatment of infected individuals. In institutions,

day care centers, and schools, control of pinworm
can be difficult, but mass drug administration
during an outbreak can be successful.

• Avoid ready made foods & drinks 33

THE END