Live female Enterobius vermicularis in the posterior fornix of the vagina of a Korean woman

Comparison of clinical and microbiological features of vulvovaginitis in prepubertal and pubertal girls

BACKGROUND/PURPOSE

Vulvovaginitisis the most common gynecological problem of childhood. The aim of the study was to determine and compare clinical and microbiological features of vulvovaginitis in prepubertal and adolescent girls.

METHODS

In this retrospective study, the records of patients who were diagnosed with vulvovaginitis between January 2005 and December 2010 in the pediatric outpatient clinic at Fatih University Hospital were retrieved. Information regarding age, symptoms, history of antibiotic use within 1 month prior to presentation, findings on urinalysis, serum antistreptolysin-O levels, and results of urine/vaginal cultures was collected.

RESULTS

The records of 112 patients were evaluated, 72 of which were prepubertal (64.2%) and 40 were pubertal (35.7%) at the time of diagnosis. Thirty-eight prepubertal patients (52.7%) had a positive result on vaginal culture, the most commonly encountered microorganism being group A beta-hemolytic streptococcus (15.2%). Culture positivity rate in the pubertal group was 47.5% (19 patients), with Candida albicans being the most frequently isolated microorganism (27.5%).

CONCLUSION

The etiopathogenesis and culture results differ between prepubertal and adolescent girls with vulvovaginitis, which should be taken into consideration in the treatment approach of this disorder.

Parents' knowledge about enterobiasis might be one of the most important risk factors for enterobiasis in children

To know the prevalence of Enterobius vermicularis infection and what are the most important risk factors, we evaluated the incidence and risk factors of enterobiasis among children attended in kindergartens in Busan metropolitan city, Republic of Korea. A total of 1,674 children from 21 kindergartens in 11 of 16 autonomous districts of Busan were evaluated for E. vermicularis infection by the cellotape anal swab technique. The overall egg-positive rate for E. vermicularis was 10.7% (179/1,674), and the prevalence of enterobiasis in each kindergarten ranged between 0% and 32.4%. There was an increasing tendency of the egg positive rate according to the population density; the higher the population density communities had, the higher egg-positive rate for E. vermicularis was detected (P = 0.001). Among personal hygiene factors involving children, thumb-sucking (P = 0.036) and fingernail-trimming (P = 0.024) were highly associated with enterobiasis. In addition, taking anthelmintic medications against E. vermicularis infection was strongly associated with enterobiasis (P = 0.014). Moreover, parents' knowledge of enterobiasis was correlated significantly with the incidence of enterobiasis of their children (P = 0.006). In conclusion, we need to consider not only personal hygiene but also parents' knowledge about enterobiasis as a factor in order to develop new strategies for elimination or to complete reduction of enterobiasis in Korea.

[Enterobiasis of the female pelvi-genital tract: a report of three cases]

Ectopic localization of oxyuriasis is rare and frequently does not cause clinical problems. It has been reported in the vagina, endometrium, fallopian tube, peritoneal surface and ovary; In these localizations it often causes pseudo-tumoral granulomas. The aim of our study was to describe etiopathogenic and clinical criteria of this rare pathology. We report one case of endometrial enterobiasis which developed in a 28-year-old women and two cases of tubo-ovarian pseudotumoral abscesses containing the ova of enterobius which appeared as a latero-uterin mass in women aged 28 and 38 years. Enterobius vermicularis may cause tubo-ovarian abscess formation with necrotizing epitheloid granulomas mimicking tumors. Antihelminth therapies are successful.

Pelvic pain caused by intraperitoneal Enterobius vermicularis (threadworm) ova with an associated systemic autoimmune reaction

AIM

The aim of this paper, based on a case study was two-fold; firstly to review the sites and gynecologic complications of ectopic Enterobius vermicularis and secondly study the autoimmune accompaniments of parasitic infestations.

METHODS

A case of intraperitoneal ectopic Enterobius vermicularis, with accompanying autoimmune signs and symptoms, is presented and its response to surgical and medical treatment described. A medical literature search was carried out into the subject of ectopic Enterobius vermicularis, particularly from the gynecologic perspective along with a study of autoimmune activation associated with parasitic infestation.

RESULTS

Pelvic pain was found to be caused by chronic inflammation from ectopic Enterobius vermicularis. This was treated both surgically and medically, with the surgical treatment proving to be inadequate but with a good response to immune modification. In the literature ectopic Enterobius vermicularis was found to be treatable surgically.

CONCLUSION

Ectopic Enterobius vermicularis was found to create symptomatic inflammatory lesions that could be treated surgically and an associated autoimmune response treatable by immune modification.

Enterobius vermicularis egg positive rates in primary school children in Gangwon-do (province), Korea

A survey of the infection rate of Enterobius vermicularis among students in 4 primary schools located in Gangwon-do (Province) was done from May to June 2001. Among the 398 examinees, 39 (9.8%) were infected with E. vermicularis demonstrated by the adhesive cellotape anal swab method. The infection rates ranged from 8.3% to 11.8% among the four schools. The infection rate of males and females was 10.7% and 7.7% respectively. The first grade students showed the highest infection rate, 28.7%. The confirmed cases were treated with albendazole three times at an interval of 15 days. We were able to confirm that E. vermicularis infection is still prevalent among students in Gangwon-do, Korea.

Chemotherapy of enterobiasis (oxyuriasis)

Enterobius vermicularis (syn. Oxyurus vermicularis), also known as pinworm or seatworm, is the causative agent of human enterobiasis (oxyuriasis). The disease is more prevalent in temperate regions and is facilitated by factors such as overcrowding in schools and family groupings, as well as inadequate personal and community hygiene. Although the infection is more likely to occur in lower socioeconomic groups, enterobiasis has been reported to affect virtually every level of the general population and especially children. In the great majority of cases, enterobiasis is asymptomatic. One common symptom is intense pruritus ani that in some patients can lead to insomnia, restlessness and irritability. Scratching may cause skin irritation, and in more serious cases, eczematous dermatitis, haemorrhage or secondary bacterial infections. Ectopic migration of E. vermicularis often results in pinworm infestation of the female genital tract often causing granulomas of the uterus, ovary and the fallopian tubes and pelvic peritoneum. Anthelmintic therapies for enterobiasis are successful and include mebendazole, albendazole and pyrantel pamoate. Mass medication of affected groups reduced symptoms rapidly, progressively and in a cost-effective way.

Relationship between pinworm and urinary tract infections in young girls

Urinary tract infection is particularly common in young girls and Enterobius vermicularis (pinworm) is one of the most prevalent worms found in children worldwide. Young girls, with or without urinary tract infection, were examined for pinworms in order to explore a possible relationship between these two problems. Of the 55 young girls with urinary tract infection, 20 (36.4%) had pinworm eggs in the perianal and/or perineal region monitored using the cellophane tape method, while 9 (16.4%) of 55 young girls who had never previously had a urinary tract infection were found to have Enterobius eggs in at least one of the cellophane tape tests, and the difference was found to be significant (p<0.05). These results suggested that urinary tract infections may be related to pinworms. When a urinary tract infection is diagnosed in young girls, cellulose tape should be applied to both the perianal and the perineal regions on at least three consecutive occasions.

An unusual over-gravid female of Enterobius vermicularis recovered from a child

An unusual over-gravid female of Enterobius vermicularis was recovered from a 15-month old child by cello-tape anal swab. The patient resided in Inchon and complained of severe anal itching. The worm measured 7.8 mm in length and 0.5 mm in width, and retained typical morphologic features of E. vermicularis such as cephalic alae and a sharply pointed posterior end. In this gravid female, peculiarly, the uterus was tremendously distended, and about 99% of the whole body length was completely packed with a great number of eggs. Other internal organs were difficult to observe. This paper describes a peculiar over-gravid female of E. vermicularis.