Enterobiasis

Enterobiasis

Enterobiosis – helminthiasis (nematodosis), manifested by itching in the perianal region and symptoms of gastrointestinal lesions. Frequency – 20% of children aged 5-10 years and 50-90% of schoolchildren. The predominant age is 5-14 years. Etiology. The causative agent is a small roundworm (nematode) Entembius (Oxyuris) vermicularis

• • Females are 5-10 mm long (up to 90% of the population), males – 3 mm. At the anterior end of the body in females there is a slight swelling (head vesicle), the terminal section is pointed (hence the name pinworm), the uterus filled with eggs shines through the body. In males, the tail end is twisted, at its end are the genital papillae. The life span of the parasite is 1-2 months. Adults live in the thick and lower

sections of the small intestine, attaching its anterior end to the intestinal wall. The eggs are colorless, transparent, with a well-defined shell, asymmetric, oval shape, one side is convex, the other is flattened. Larvae are clearly visible in the eggs. Epidemiology. The disease is registered everywhere. The reservoir and source of invasions is a sick person. The mechanism of transmission is fecal-oral, the main ways of infection are food and household. Larvae in eggs mature within 4-5 hours, after which they become invasive. When combing the skin, the eggs fall under the nails, on the linen, and then on the dishes, toys, are brought into the mouth and swallowed. In the intestine, the larvae emerge from the eggs and develop into adults. Fertilized females crawl out through the anus (more often during sleep) and lay 5,000-15,000 eggs on the skin of the perianal region and perineum. Migration of females is accompanied by itching. Eggs can fall on the hands when scratching the skin within the anus. In organized groups, the infection rate of babies can reach 20-30%. Infected persons are dangerous in 12-14 days after infection. The excretion of eggs by the parasite is saved until a complete cure.

Clinical picture

• • Incubation period – 2-4 weeks
  • Most cases are asymptomatic
  • Characterized by perianal itching (traditionally in the evening and at night), local skin irritation, sleep disturbance and high fatigue
  • Massive invasions lead to abdominal pain, loss of appetite, insomnia, which is due to the mechanical effect of the parasite on the intestinal wall, intoxication, allergization of the body by helminth metabolites, and violation of intestinal microbial cenosis.
  • Not often, pinworms penetrate the female genital tract, causing vaginitis, endometritis, salpingitis
  • Often helminths are found in the appendix.

 

Research method

• • Detection of eggs by microscopy of material obtained by scraping from the mucous membrane of the rectum and skin of the perianal region
  • Scrapings are carried out immediately after awakening. If the result is negative and to increase the reliability of the diagnosis, the procedure is carried out at least 3 times with an interval of 2-3 days
  • The effectiveness of the method with a single study does not exceed 50% of cases, with a three-time study – 90%, five times – 99%. Differential Diagnosis
  • Allergic dermatitis
  • Lichen planus
  • Psoriasis
  • contact dermatitis
  • papillomavirus infection
  • Herpes simplex
  • Scabies
  • erythrasma
  • Mycoses.

 

Treatment

• • Pyrantel pamoate 10 mg/kg (not more than 1 g) as a single dose (after breakfast). Should be used with caution in children under 2 years of age. In some cases, nausea, vomiting, diarrhea, dizziness are possible.
  • Mebendazole 100 mg as a single dose (children from 2 to 10 years old – 2.5-3 mg / kg). In case of re-invasion, the treatment is repeated after 2-4 weeks.
  • Drugs are contraindicated in pregnancy
  • Recommended prophylactic treatment of all family members of the sick person
  • The effectiveness of treatment is determined within 3 weeks, starting from 14 days after the end of treatment. Recovery is confirmed by the negative results of three studies of perianal scrapings, carried out with an interval of 1-2 days.

Prevention. Examination of babies, staff of preschool institutions and elementary school students at least 1 r / year

• • Strict sanitary and disinfection regime in preschool institutions
  • Examination of each newly admitted child and treatment if necessary
  • Examination of food workers and persons equated to them
  • If enterobiasis is detected, it is recommended to carry out a daily morning and evening toilet of the perianal area with soap and water and wear closed underpants. The patient’s underwear is boiled every day and ironed with a hot iron. Bed linen is ironed with a hot iron every 2-3 days. In the room where the patient is located, wet cleaning is carried out. Dishes, chamber pots and children’s toys are periodically scalded with boiling water.
  • Dispensary observation of the sick – 1.5 months.

Synonym. Oxyurosis ICD. B80 Enterobiosis Literature. 129:296-297