Enterobiasis (also called pinworm, seatworm, or threadworm infection, or oxyuriasis) is a benign intestinal disease caused by the nematode Enterobius vermicularis. Found worldwide, even in temperate regions with good sanitation, it's the most prevalent helminthic infection in the United States.
Adult pinworms live in the intestine; female worms migrate to the perianal region to deposit their ova. Direct transmission occurs when the patient's hands transfer infective eggs from the anus to the mouth. Indirect transmission occurs when he comes in contact with contaminated articles, such as linens and clothing.
Enterobiasis infection and reinfection occur most commonly in children between ages 5 and 14 and in certain institutionalized groups because of poor hygiene and frequent hand-to-mouth activity. Crowded living conditions increase the likelihood of it spreading to several members of a family.
Asymptomatic enterobiasis is commonly overlooked. However, intense perianal pruritus may occur, especially at night, when the female worm leaves the anus to deposit ova. Pruritus causes irritability, scratching, skin irritation and, sometimes, vaginitis. Rarely, complications include appendicitis, salpingitis, and pelvic granuloma.
CONFIRMING DIAGNOSIS A history of anal pruritus suggests enterobiasis; identification of Enterobius ova recovered from the perianal area with a cellophane tape swab taken before the patient bathes and defecates in the morning confirms it. A stool sample is usually ova- and worm-free because the worms deposit ova outside the intestine and die after return to the anus.
Drug therapy with pyrantel, mebendazole, or albendazole destroys the causative parasites. Effective eradication requires simultaneous treatment of the patient's family members and, in institutions, other patients.
❑If the patient receives pyrantel, tell him and his family that this drug colors the stool bright red and may cause vomiting (vomitus will also be red). The tablet form of this drug is coated with aspirin and should'nt be given to aspirin-sensitive patients.
❑To help prevent this disease, tell parents to bathe children daily (showers are preferable to tub baths) and to change underwear and bed linens daily.
❑Tell the patient's family not to shake bed linens, to avoid aerosolization of eggs that may be on linens.
❑Educate children in proper personal hygiene, and stress the need for proper hand hygiene after defecation and before handling food. Discourage nail biting. If the child can't stop, suggest that he wear gloves until the infection clears.
❑Report all outbreaks of enterobiasis to school authorities.
❑Tell parents to strictly adhere to the prescribed drug dosage as directed by a physician.
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Copyright notice for book excerpts: Copyright © 2008 Lippincott Williams & Wilkins. All rights reserved.
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Title: Professional Guide to Diseases (Eighth Edition) Authors: Springhouse Publisher: Lippincott Williams & Wilkins Copyright: 2005 ISBN: 1-58255-370-X 
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