Clinical signs

Most pinworm infections are asymptomatic. When symptoms occur, it is usually in the form of itching from the anus area. Itching is usually worse at night when migration of females and egg deposition occurs. The degree of symptoms are related to the parasite load. Pruritus at night may disturb the sleep for affected children and certainly are an annoyance in the daily life of the affected family. The medical importance of the disease is otherwise small. Some worms may find their way into adjacent orifices, most commonly the female genitourinary tract, producing irritative symptoms such as vulvovaginitis and cystourethritis. Case reports of extra-intestinal infestation by enterobius in the peritoneal cavity, endometrium, lungs, liver, and other organs occur, but mainly from developing countries where high parasite loads could be expected in many patients (Arora et al. 1997; al-Rufaie et al. 1998). Secondary bacterial infections after itching have been reported in children with atopic dermatitis. The worms probably do not cause appendicitis, even if some studies have suggested such a connection (Dahlstrom and Macarthur 1994; Makni et al. 1998). Thus, itching, sleeping problems, and possible psychological effects because of fear of worms remain the main clinical features of this infection.

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