Welcome back to all of my US readers from the Thanksgiving holiday. Here is a fun case with the answer embedded - just listen to the audio with the video. Or if you'd prefer, keep the volume down and give your best guess on what you think this is!
This case is donated by Dr. Jessica Lin and her colleague who is field physician in Tanzania. The patient is a 4 year old boy with anal pruritus and history of passing worms from his anus. Several white-tan worms measuring ~5mm long were examined:
7 comments:
Well, this is a classic situation. Children by nature are very altruistic, sharing their prize possessions I.e M&M’s. The asymmetric eggs with a flat side and a convex side are commonly shared in this fashion. The nocturnal anal itch may be subconsciously relieved when the mother worm comes out for her brood discharge. Not only young children are affected but neglected elderly people in geriatric institutions are infected also. At this we also see the benefits of a diagnostic repeated Scotch tape performed before the morning bowel movement, we may remind all clinicians to only use the old transparent tape rather than the “magic” frosted type as this one is not suitable for microscopy. These pesky pin worms AKA Enterobius vermicularis are very “Equal Opportunity”. They victimized the common sharecroppers to people in highest rungs of the society.
Florida Fan
Enterobius vermicularis (pinworm, nematode). The extensive uterine reproductive system of the fertilized female worm is often completely filled with double-layered, elongate-oval eggs.
In Europe prevalence among kindergarten and primary-school kids are generally about 20%. The main risk factors are age 4–11 years, uncontrolled anus-finger-mouth contact, nail-biting, unsupervised body hygiene, and poor compliance with basic hand hygiene.
Antihelminthic treatment along with hygienic measures can successfully eradicate pinworm infection and prevent recurrence and autoinfection.
Nice video material from Enterobius vermicularis, the "human pinworm", or sometimes also called the "seatworm".
I seem to recall someone once saying that -even in high-income countries- by the time we get old, more than 90% of the people comes into contact with pinworms.
Let me rephrase that: "more than 90% has (at least once in their lifetime) been into contact with pinwomrms."
Enterobius vermicularis
Pinworm. Enter Enterobius vemicularis
Pinworm. Enterobius vemicularis
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