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PubMed1997

Eosinophilic ileocolitis by Enterobius vermicularis: a description of two rare cases.

BACKGROUND: Human enterobiasis is usually mild. Occasionally, however, an "ectopic" disease may occur with a more severe course. Two rare cases of eosinophilic ileocolitis due to Enterobius vermicularis infection are reported here. CASE REPORTS: Case n degree 1 was 46 years old, presenting with fever and bloody diarrhoea. Blood eosinophilia was present. Stool microscopy demonstrated red blood cells and leukocytes. A 2 mm long worm with bilateral cervical wings was found in wet-mount preparations of faecal samples. The Scotch tape test was positive for Enterobius vermicularis eggs. Colon biopsy specimens showed massive eosinophilic infiltration and a typical pinworm section overlying the infiltrated mucosa. Case n degree 2 was a 24-year-old, anti-HIV negative homosexual, presenting with watery diarrhoea. Tests for malabsorption were negative. Three mm long adult male E. vermicularis were found on stool microscopy. Biopsy specimens from the colon showed eosinophilic infiltration. In both cases a 200 mg/day course of oral mebendazole eliminated the symptoms within 3 days. CONCLUSIONS: In these two cases the clinical presentation of enterobiasis was atypical. A common finding was the eosinophilic infiltration of bowel mucosa, although it is still uncertain whether the worm per se may induce mast cell degranulation and eosinophil activation. Nevertheless, the possibility of Enterobius vermicularis infection should be considered in the presence of eosinophilic ileocolitis.

Adult↗

PubMed1990

The presence of pinworms (Enterobius sp.) in the mesenteric lymph nodes, liver and lungs of a chimpanzee, Pan troglodytes.

This report describes a case of fatal enterobiasis caused by Enterobius sp. in the mesenteric lymph nodes, lymphatic vessels of mesentery, blood vessels of the liver and lungs of a chimpanzee from Qingdao Zoo, China. Based on pathological findings, it is likely that the pinworms obtained access to these organs via the lymphatic or haematogenous pathway. As far as we are aware, this is the first reported case of Enterobius sp. in the mesenteric lymph nodes and blood vessels of the lungs and veins of the hepatic triad in a chimpanzee.

Animals↗

PubMed1983

[Enterobius gregorii (Oxyuridae, Nematoda), a new human parasite].

A review of the Oxyurids parasites of Primates shows that most of the species described in the Malagasy Lemurs and in the Old World Monkeys are not single species, but couples of sister-species. The sister-species of each couple may be differentiated sometimes only by the characteristics of male spicule (less evoluated species), sometimes by other characteristics (cephalic structures, length of oesophagus, etc., in more evoluated species). In the first instance only males can be identified, in the second instance females may also be identified. In the Human parasites, which are very closely related to those of the Old World Monkeys, two types of spicules were described and we consider that each type belongs to a different species: Enterobius vermicularis (L., 1758) for the larger spicule (100 to 122 micrometers), and Enterobius gregorii n. sp. for the shorter spicule (70 to 80 micrometers).

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PubMed2003

Growth of Enterobius vermicularis in a chimpanzee after anthelmintic treatment.

The growth of Enterobius vermicularis in a chimpanzee was investigated by observing worms discharged in feces after administration of pyrantel pamoate. Just after the final molting, immature adult male pinworms developed to a fully mature stage in 2 wk, after passing through a stage corresponding to the so-called Enterobius gregorii, which was surmised to be a younger adult form of E. vermicularis. The frequency distribution of body length forms 2 peaks in both male and female pinworms, with a depression in the transitional forms from the immature to the fully mature stage. This depression seems to be the result of more rapid growth or lower susceptibility to the drug in this transitional stage. Pyrantel pamoate effectively eradicated mature males, but gravid females were continuously observed in the feces after treatment. The complete eradication of pinworm infection by pyrantel pamoate could be achieved by repeated treatment at intervals shorter than 2 wk. This treatment would eradicate male worms first, resulting in females producing only unfertilized eggs, from which only males might hatch.

Animals↗

PubMed1991

Enterobius egg granuloma of the vulva and peritoneum: review of the literature.

Two cases of Enterobius granuloma containing eggs only are reported. The first case involved the vulva, where no such granuloma has been reported previously. The coexistence of peritoneal granuloma and rectal adenocarcinoma in the second case suggests the possibility of direct penetration of the damaged colonic wall by the parasite, as emphasized by several previous reports of neoplastic involvement and perforation of the intestinal wall in cases of ectopic infections. The diagnostic criteria of Enterobius eggs granuloma, which might be a diagnostic dilemma for pathologists who are not familiar with such criteria, are described herein.

Adult↗

PubMed1986

[Eggs of Enterobius vermicularis in vaginal smears].

The technique of exfoliative cytology is used especially for early cancer diagnosis with cervical and vaginal smears. In these smears, some parasites eggs can be seen together with some kind of cells. One of these parasites is Enterobius vermicularis. Normally, this is intestinal parasite. But sometimes, especially in children, this parasite eggs can migrate in vagina by itching, and can cause vaginal discharge. The shape of egg is, one border is flat but the other is convex, and it may contain larva inside. We also observed the egg of Enterobius vermicularis which contains larva inside with squamous epithelial cells and polymorphonuclear leucocytes in a vaginal smear. As is seen, routine Papanicolaou smears are very useful to see unusual eggs of parasites during cancer detection.

Adult↗

PubMed1996

[Enterobius vermicularis localized to the internal female genitalia].

Enterobius vermicularis is one of the most common helminthic infections in humans. It normally inhabits the large intestine and is of low pathogenecity. The ova are, however, occasionally found in ectopic sites in the peritoneal cavity, usually as asymptomatic granulomas, though in rare cases they may cause chronic lower abdominal pain. Two cases of ectopic enterobius vermicularis are presented in this paper.

Adult↗

PubMed1998

Is Enterobius gregorii Hugot, 1983 (Nematoda: Oxyuridae) a distinct species?

A series of 849 male pinworms collected from a 64-yr-old Japanese male was examined. They were classified by the spicule morphology into 87 Enterobius vermicularis (Linnaeus, 1758), 754 Enterobius gregorii Hugot, 1983, and 6 immature adults, whereas 2 worms lacked spicules. The worm length of E. vermicularis was significantly larger than E. gregorii. The shape and length of the distal tubular portion of the spicule were identical in these forms, whereas the basal portion was different. The immature adults just after the final molt or still within the cuticle of the fourth stage had only a distal tubular portion, indicating that the basal portion is added during subsequent development. Moreover, various transitional forms were observed in the spicule morphology in the worms with intermediate body size between E. vermicularis and E. gregorii, showing that the basal portion of the spicule of E. vermicularis develops after the completion of E. gregorii-type basal portion. It is suggested that E. gregorii is a young stage of E. vermicularis.

Animals↗

PubMed1977

Unilateral salpingitis due to Enterobius vermicularis.

A case of perforated unilateral salpingitis in which Enterobius vermicularis ova were identified in the inflammatory process is reported. Arguments for considering the parasite to be of etiologic significance in the production of the pathologic changes and clinical symptoms are presented. The infrequent occurrence of symptoms associated with ectopic localization of Enterobius vermicularis is emphasized by a review of the literature.

Adult↗

PubMed1994

Enterobius vermicularis: a possible cause of symptoms resembling appendicitis.

The role of Enterobius vermicularis in appendicitis has been disputed. The aims of this retrospective study were to determine the prevalence of E. vermicularis in surgically removed appendices and to relate this to the age and sex of the patient, the time of the year, the presence of symptoms and the histological findings. The study included all appendices received in this laboratory during the 5 year period from 1984 through to 1988. There were 1867 appendices during this period of which 1108 were acutely inflamed and 759 were not inflamed (although 149 of these showed other pathological changes). The mean age distribution of all patients was 22.8 years. Enterobius vermicularis was identified in 63 appendices (3.4%). Infestation was more frequent in female (4.6%) than in male (1.9%) patients. The peak age was 12.8 years in females and 12.1 years in males. Of 63 patients who had E. vermicularis, 98% presented with symptoms of acute or recurrent appendicitis, yet 40 had no histological evidence of appendicitis or mucosal invasion by the parasite and only four had other possible explanations for abdominal pain. In an analysis of the subgroup of 147 patients who had incidental appendectomy at the time of laparotomy for other reasons, only one had E. vermicularis. It is concluded that E. vermicularis occurs more frequently in uninflamed appendices. It may be a cause of symptoms resembling acute appendicitis although the mechanism for this does not involve mucosal invasion by the parasite.

Acute Disease↗

PubMed1981

Enterobius vermicularis infestation of the female genital tract causing generalised peritonitis. Case report.

Enterobius (Oxyuris) vermicularis is the only nematode which infests man. It inhabits the large intestine and is of low pathogenicity. The ova are occasionally found in ectopic sites within the peritoneal cavity, usually as an asymptomatic granuloma. We describe the first patient to present with generalised peritonitis caused by rupture of a tubo-ovarian abscess containing the ova of Enterobius vermicularis.

Abscess↗

PubMed1977

Evaluation of anthelmintic treatment of Enterobius vermicularis infection in highly endemic population by prolonged observation.

To evaluate the efficacy of anthelmintic treatment of Enterobius vermicularis in highly endemic population, total 82 children in two orphanage institutes were divided into 4 groups and treated with placebo, 5 mg/kg of pyrvinium pamoate, 100 mg of mebendazole and 10 mg/kg of pyrantel pamoate respectively. Total 4 anal swabs were taken from each child before treatment and the even distributions of positive rate and consecutive results between groups were considered. Follow-up swabs were taken 8 times up to the 40th day after treatment. After remarkable and significant reduction of positive rates up to 19-27th day after treatment in respective groups, the remarkable egg positive conversions were observed 3-4 weeks after treatment. The positive conversion was the earliest and the most remarkable in pyrantel-treated children and the slowest and the least remarkable in mebendazole-treated cases. Also found was that the figures of negative conversion were different with statistical significance between two categories of cases, consecutively positive and alternately positive cases of pre-treatment swabs. This means that the conventional indices of cure rate in E. vermicularis infection may be variable by the selection of subjected cases. Above results mean that the spectrum of susceptible pinworms according to the developmental stages are different between currently available drugs, and the ability to remove pinworms completely in certain developmental stage are also different between chemotherapeutics. These results suggest the need of interval chemotherapy of Enterobius vermicularis infection in heavily infected cases of in highly endemic population to achieve the complete eradication of whole range of pinworms in intestine.

Journal Article↗

PubMed1985

Effect of anthelmintics on the early stage of Enterobius vermicularis.

In order to determine the susceptible age of Enterobius vermicularis to anthelmintics and to observe the chronologic growth of female E. vermicularis in man, experimental infections were done. About 500 eggs were challenged to 19 volunteers. After 4, 8, 16, 20, 24, 28, 32 and 35 days of infection, each case was treated by either mebendazole or pyrantel pamoate. On the 40th day of infection all cases including control were treated again to terminate the expermental infection and to evaluate the effect of previous treatment. Each case collected 3-day stools to harvest the expelled worms. The results could be summarized as follows: The infection rates of females were in range of 0.6~13.1% in control cases. Because the collected worms showed comparable growth and development by day, the worns were concluded to be derived from experimental infection. Cases that were treated with mebendazole on 4, 8 and 16 days after infection expelled 37.5%, 2.5% and 67.5% of the number expelled by a control case on the 40th day. Cases treated thereafter expelled no worms on the 40 days. Cases that were treated with pyrantel pamoates on 4, 8, 16, 24, 28, 32 and 35 days, expelled 90.7%, 25%, 45.3%, 8%, 2.7%, 5% and 29.3% of the number collected from control cases in respect. All the worms collected were females. The total body length increased consistently and comparably from the 20th day of infection. Those collected on the 20th day were 2.5~3.0 mm long with vigina, sac-like structure and strands of ovaries; 24 day-old worms may have short uterus, 28 day-old worms had long uterus without eggs, 32 day-old worms began to produce eggs, 35 day-old worms showed wide variations in egg deposit in uterus, and 40 day-old worms had uterus filled with eggs from vulva to anal levels. From the above results, it was inferred that the life span of female Enterobius vermicularis was longer than 40 days, and the developmental stages of worms younger than 16 days resisted considerably to both mebendazole and pyrantel pamoate.

Journal Article↗

PubMed1992

Perianal mass and recurrent cellulitis due to Enterobius vermicularis.

A unique case of enterobiasis presenting as recurrent cellulitis and a perianal mass in a six-year-old girl is reported. Complicated perianal lesions due to Enterobius are unusual. Only 10 previous cases are known, with unclear pathogenesis in most of them, although mucosal breaches and perianal crypt or gland entry have been postulated. The association of the mass in this case with a deep crypt, and the histopathologic finding of squamous epithelium focally surrounding the granulomatous reaction to the Enterobius eggs suggest that the worm entered the perianal tissues via a crypt. Local secondary bacterial infection can cause significant morbidity. Surgical excision of such granulomatous mass lesions is necessary in symptomatic or complicated cases.

Anus Diseases↗

PubMed1987

Role of Enterobius vermicularis in the aetiology of appendicitis.

An evaluation was made of the histological material obtained from all 1529 appendices removed during the last 5 years at Southmead Hospital, Bristol, in order to elucidate possible relationships between the incidence of Enterobius vermicularis and the origin of inflammation in the appendix. In total, 1419 appendices were removed as cases of clinical appendicitis and 110 in the course of another surgical procedure. E. vermicularis was identified in 2.7 per cent of patients with clinical appendicitis and was most commonly seen in appendices with either chronic inflammation or where the appendix was histologically normal. E. vermicularis was rarely associated with histological changes of acute appendicitis. No cases of E. vermicularis infestation occurred in appendices removed during the course of other surgical procedures. The results suggest that, although E. vermicularis may have a causal role in appendicular pain and chronic inflammation, it is rarely related to acute appendicitis.

Animals↗

PubMed1988

Sex, Enterobius vermicularis and the appendix.

Examination of 182 appendices containing Enterobius vermicularis demonstrated that male pinworms are seen more commonly than female. There was no association between the sex of pinworms and inflammation in the appendix but inflammation was frequently seen in association with luminal ova. Ova release from female pinworms may be a feature of appendiceal obstruction.

Acute Disease↗

PubMed2006

Mitochondrial cytochrome c oxidase subunit 1 gene and nuclear rDNA regions of Enterobius vermicularis parasitic in captive chimpanzees with special reference to its relationship with pinworms in humans.

Sequences of mitochondrial cytochrome c oxidase subunit 1 (CO1) gene, nuclear internal transcribed spacer 2 (ITS2) region of ribosomal DNA (rDNA), and 5S rDNA of Enterobius vermicularis from captive chimpanzees in five zoos/institutions in Japan were analyzed and compared with those of pinworm eggs from humans in Japan. Three major types of variants appearing in both CO1 and ITS2 sequences, but showing no apparent connection, were observed among materials collected from the chimpanzees. Each one of them was also observed in pinworms in humans. Sequences of 5S rDNA were identical in the materials from chimpanzees and humans. Phylogenetic analysis of CO1 gene revealed three clusters with high bootstrap value, suggesting considerable divergence, presumably correlated with human evolution, has occurred in the human pinworms. The synonymy of E. gregorii with E. vermicularis is supported by the molecular evidence.

Animals↗

PubMed2006

SL1 RNA gene recovery from Enterobius vermicularis ancient DNA in pre-Columbian human coprolites.

Enterobius vermicularis, pinworm, is one of the most common helminths worldwide, infecting nearly a billion people at all socio-economic levels. In prehistoric populations the paleoparasitological findings show a pinworm homogeneous distribution among hunter-gatherers in North America, intensified with the advent of agriculture. This same increase also occurred in the transition from nomad hunter-gatherers to sedentary farmers in South America, although E. vermicularis infection encompasses only the ancient Andean peoples, with no record among the pre-Colombian populations in the South American lowlands. However, the outline of pinworm paleoepidemiology has been supported by microscopic finding of eggs recovered from coprolites. Since molecular techniques are precise and sensitive in detecting pathogen ancient DNA (aDNA), and also could provide insights into the parasite evolutionary history, in this work we have performed a molecular paleoparasitological study of E. vermicularis. aDNA was recovered and pinworm 5S rRNA spacer sequences were determined from pre-Columbian coprolites (4110 BC-AD 900) from four different North and South American archaeological sites. The sequence analysis confirmed E. vermicularis identity and revealed a similarity among ancient and modern sequences. Moreover, polymorphisms were identified at the relative positions 160, 173 and 180, in independent coprolite samples from Tulán, San Pedro de Atacama, Chile (1080-950 BC). We also verified the presence of peculiarities (Splicing leader (SL1) RNA sequence, spliced donor site, the Sm antigen biding site, and RNA secondary structure) which characterise the SL1 RNA gene. The analysis shows that the SL1 RNA gene of contemporary pinworms was present in pre-Columbian E. vermicularis by 6110 years ago. We were successful in detecting E. vermicularis aDNA even in coprolites without direct microscopic evidence of the eggs, improving the diagnosis of helminth infections in the past and further pinworm paleoepidemiological studies.

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