Unusual Endoscopic and Microscopic View of Enterobius Vermicularis: A Case Report With a Review of the Literature

Michelle Petro, MD; Kalyana Iavu, MD; Anil Minocha, MD

Disclosures

South Med J. 2005;98(9):927-929. 

In This Article

Abstract and Introduction

Enterobius vermicularis has the broadest geographic range of any helminth and is the most common intestinal parasite seen in the primary care setting. Underappreciated is the fact that it is not always a benign disorder and could even cause life-threatening medical problems. Visualization of the actual worms during endoscopy is probably underappreciated in part because endoscopists have never actually seen the worm and/or are not actively looking for, or anticipating, worms. This report describes a case of worm infection as documented during colonoscopy and confirmed by microscopy. The gross and microscopic appearance of the worm is described. Literature regarding the wide range of gastrointestinal and nongastrointestinal manifestations, including potentially life-threatening illnesses, as well as treatment options, are also reviewed.

Enterobius vermicularis is a nematode and has the broadest geographic range of any helminth.[1] Since the first evidence of pinworm infection from Roman-occupied (30 BC to AD 395) Egypt,[2] it has been known to be the most common intestinal parasite seen in the primary care setting, regardless of race, socioeconomic status, or culture.[3] Although infection with this worm is usually thought to be asymptomatic or to cause nuisance symptoms such as perianal itching, this worm can cause severe and even life-threatening illnesses,[4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26] including fatality in primates.[27] Visualization of the actual worms during endoscopy is unusual and probably underappreciated, in part because most endoscopists have never seen these worms in real life and are not consciously looking for worms. We present a case of a worm infection as documented during colonoscopy and confirmed by microscopy.

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