Pinworm

Background

Two pinworms next to a ruler: The markings are 1 mm apart.

Enterobius vermicularis

• Enterobius

Clinical Features

• Nocturnal perianal itch

Differential Diagnosis

Helminth infections

Cestodes (Tapeworms)

• Taenia saginata
• Taenia solium (Cysticercosis)
• Diphyllobothrium latum
• Hymenolepis nana
• Echinococcus granulosus

Trematodes (Flukes)

• Fasciola hepatica
• Fasciolopsis buski
• Opistorchis viverrini
• Schistosoma spp
  • Schistosomiasis
• Chlonorchis sinensis
• Paragonimus spp.

Nematodes (Roundworms)

• Ascaris lumbricoides
• Enterobius vermicularis (Pinworm)
• Filarial worms
  • Loa Loa
  • Onchocerciasis
  • Lymphatic filariasis (Elephantiasis)
    • Wuchereria bancrofti
    • Brugia malayi
    • Brugia timori
• Hookworm
  • Necator americanus
  • Ancylostoma duodenale
  • Cutaneous larva migrans (Ancylostoma braziliense)
• Dracunculus medinensis
• Strongyloides stercoralis
• Trichuris trichiura (Whipworm)
• Anisakis
• Toxocara spp.
• Trichinosis

Evaluation

• Cellophane tape test to be followed up as outpatient

Management

Treatment targeted against Enterobius vermicularis

• Mebendazole 100mg PO once THEN repeat in 2 weeks OR
• Albendazole 400mg PO once (100mig if < 2yo) THEN repeat in 2 weeks OR
• Pyrantel Pamoate (Pin-x) 11mg/kg (max 1g) THEN repeat in 2 weeks
  • Recommended for pregnant patients

Consider treatment for the household.

Disposition

Discharge with oral treatment

See Also

• Parasitic Diseases
• Travel Medicine

References

• Kost,S.: Pinworms In Fleisher and Ludwig's 5-Min Pediatric Emergency Consult, Lippincot WIlliams & Wilkins, Pages 748-749
• Elliot, D: Feldman: Sleisenger and Fordtran's Gastrointestinal and Liver Disease, 9th ed., Saunders, 2010, (Ch)110 p:1928

Authors

Ross Donaldson, Kevin Lu, Daniel Ostermayer, Aaron Snyder, Neil Young