Threadworms (pinworms)

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Threadworms, also known as pinworms, are tiny parasitic worms that infect the large intestine of humans.

Causes

  • Enterobius vermicularis
  • Poor Hygiene

Signs and symptoms

  • Vague abdominal pain
  • Perianal itching
  • Iron deficiency anaemia
  • Rectal prolapse
  • Diarrhoea
  • Weight loss
  • Mild nausea

Investigations

  • Identification of the adult worm from stool or vomitus
  • Stool microscopy (fresh sample): recognition of the eggs of the worm using the cellophane tape applied to the anus.

Treatment objectives

  • Eliminate the worm
  • Ensure proper sanitation
  • Treat complications of infestation e.g. anemia , malnutrition

Non-pharmacological treatment

  • Educate about:
    • The disease.
    • Proper hand washing after using the toilet.
    • Better preparation of food by adequate washing and cooking.

Pharmacological treatment

First line treatment

Mebendazole, oral

Adult: 100 mg every 12 hours for 3 days 

OR

500 mg as single dose immediately

Child:

 > 2 years: 100 mg every 12 hours for 3 days or 500mg as a single dose

 

Second line treatment

Albendazole, oral

Adult:

400mg as a single dose

Child:

2 years and above: 400 mg as a single dose

One year to less than 2 years: 200mg as a single dose

Referral

  • All patients with mechanical obstruction and complications related to migration of worm larvae must be referred for specialist care.