<i>Enterobius vermicularis</i> Infection with Tuboovarian Abscess and Peritonitis Occurring during Pregnancy

Craggs, Barbara; Waele, Elisabeth De; Vogelaere, Kristel De; Wybo, Ingrid; Laubach, Monika; Hoorens, Anne; Waele, Boudewijn De

doi:10.1089/sur.2008.090

Cited by 33 publications

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“…Less commonly, the adult worms can become lodged in the intestinal mucosa and cause intestinal abscess (2). Extraintestinal enterobiasis is rare and mostly involves the female genital and reproductive tract, which includes the vagina, uterus, ovaries, fallopian tubes, and pelvic peritoneum or even the human embryo (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15). In addition, recurrent urinary tract infections (UTIs) as a complication of aberrant migration in women, particularly in young girls, have also been identified (16,17).…”

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“…Moreover, the preoperative symptoms and complaints, including lower abdominal pain, fever, dyspareunia, nausea, and vomiting, are usually nonspecific, while results of biochemical examination such as blood test also lack specificity (3,(6)(7)(8)(9)(10)(11). Histological examination is also difficult, as the egg of this parasite might be easily confused with Schistosoma eggs, particularly in the epidemiological setting, in which infections by both species are endemic.…”

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“…Alternatively, a single dose of mebendazole may also be given to the patient followed by a second dose in cases where the infection persists, typically as a result of autoinfection. In most reported cases, patients were treated with mebendazole after surgery (3)(4)(5)(6)(7)(8)(9)(10)(11). However, the use of mebendazole in pregnancy remains controversial with regard to fetus safety (9).…”

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Enterobius vermicularis Salpingitis Seen in the Setting of Ectopic Pregnancy in a Malaysian Patient

et al. 2014

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c We report a rare and unusual case of invasive Enterobius vermicularis infection in a fallopian tube. The patient was a 23-year-old Malaysian woman who presented with suprapubic pain and vaginal bleeding. A clinical diagnosis of ruptured right ovarian ectopic pregnancy was made. She underwent a laparotomy with a right salpingo-oophorectomy. Histopathological examination of the right fallopian tube showed eggs and adult remnants of E. vermicularis, and the results were confirmed using PCR and DNA sequencing. CASE REPORTO n 22 January 2014, a 23-year-old woman, who was in her second pregnancy and at 8 weeks of gestation, presented as an outpatient to the Emergency Department (ED) University of Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia. She was referred by a private general practitioner after complaining of vaginal bleeding for 3 days with small amount of spotting and staining on her undergarment associated with suprapubic pain for a day. The pain was described as sharp pricking, nonradiating, and progressively increasing in severity. She did not have any vaginal discharge or fever. The result of a urine pregnancy test carried out at the private clinic was positive. When she missed her menses in December 2013, no test was done to confirm pregnancy. Bowel and urinary habits were normal. She did not have any medical illnesses or previous surgeries. No known allergies were noted. She had a full-term vaginal delivery in 2009. She attained menarche at the age of 12 years and has a regular menstrual cycle and is free of menorrhagia, dysmenorrhea, dyspareunia, and postcoital bleeding. She is on a natural method of contraception, and a cervical smear test had never been done before.On physical examination, she appeared pale, with early signs of hypovolemia as evidenced by tachycardia with pulse rate of 110 to 120 beats per min and blood pressure ranging between 90 to 94 and 60 to 70 mm Hg. Fluid resuscitation was immediately started in the emergency department. Her vital signs were monitored continuously. Cardiorespiratory examination revealed no abnormalities. Her abdomen was mildly distended. There was presence of tenderness at the lower abdomen with guarding. Neither an abdominal scar nor organomegaly was noted. Vaginal examination revealed a normal vulvovaginal surface, and her cervix was tubular. The cervical excitation result was positive, with fullness in the Pouch of Douglas. Adnexal tenderness was elicited bilaterally.Transabdominal pelvic sonography revealed an empty uterus with a right irregular adnexal mass measuring 9 mm and a moderate level of free fluid that was 50 mm deep. Blood investigations revealed anemia, with hemoglobin at 6.7 g/dl and with a normal white blood cell count and platelet level. Preoperative diagnosis of a ruptured right ectopic pregnancy with hypovolemia was made. Informed consent for a laparotomy was provided by both the patient and her husband after they were counseled with respect to the working diagnosis and the intended procedure. She underwent laparotomy with right salp...

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Enterobius vermicularis Salpingitis Seen in the Setting of Ectopic Pregnancy in a Malaysian Patient

et al. 2014

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“…The most common extraintestinal site is the female reproductive tract (vagina, uterus, ovaries, and fallopian tubes) due to migration of the female worm from the anus (6,15,16). The female worm can also enter the urinary tract (17), kidneys (4), and biliary tract and liver (12).…”

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“…In the 1976 report by Dutta and Kalita (7), the patient was treated with a wash solution made of oral piperazine citrate diluted in water. In cases where the worms become lodged in tissue such as the appendix or ovaries (6,8), surgery is performed to remove the worm, followed by treatment with mebendazole. In our case, the patient was treated with an extended course of mebendazole, following which there was resolution of her symptoms.…”

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Enterobius vermicularis in a 14-Year-Old Girl's Eye

et al. 2011

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We report an unusual case of extraintestinal infection with adult Enterobius vermicularis worms in the nares and ocular orbit of a 14-year-old girl in Illinois. Only one other similar case has been reported in the English-language literature. CASE REPORTA 14-year-old Caucasian girl presented to the local emergency department (ED) after having removed and discarded what she described as a small motile worm from her eye the night before. On physical examination, she appeared well and her vision was normal. Ocular exam by a nurse revealed a single motile worm beneath the right lower lid in the inferior conjunctival sac which was removed on a cotton swab. The patient was also seen by a physician's assistant who identified and removed three additional worms over a 60-min period. The patient was then seen by an ED physician, and ophthalmology and infectious diseases specialists were consulted.

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Vulvovaginitis due to Enterobius vermicularis in a girl and epidemic enterobiasis in her family

Davoodi,

Soleymani,

Oladi

et al. 2024

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Key Clinical MessageHere we present a case of a 4‐year‐old girl who suffered from vulvovaginitis caused by Enterobius vermicularis. All members of her family were also infected by this helminth. Treatment with mebendazole was administered to all family members and it was found that the entire family had been cured.AbstractVulvovaginitis, an inflammation of the vulvovaginal mucous membranes, is a common reason for pediatric gynecology consultations. One of the causes of this condition is a parasitic worm known as Enterobius vermicularis (E. vermicularis). In girls, adult worms can infiltrate the vagina and release eggs, leading to the development of vulvovaginitis. Furthermore, these worms have the ability to invade the endometrial cavity too. Here we present a case of a 4‐year‐old girl who suffered from vulvovaginitis caused by E. vermicularis. All members of her family were also infected by this parasitic helminth. In the vaginal sample, apart from the eggs, the female adult worm was observed under the microscope. Treatment with mebendazole was administered to all family members, and their progress was followed for a period of 3 weeks, during which it was found that the entire family had been cured. This patient experienced significant improvement in symptoms related to severe anxiety, nervousness, vaginal inflammation, itching, and vulvovaginitis caused by E. vermicularis. To prevent infection by E. vermicularis, it is crucial to disinfect underwear and bed sheets. In kindergartens, the spread of this parasite should not be underestimated, and asymptomatic individuals who have been exposed to infected persons should receive treatment to prevent an epidemic. Maintaining cleanliness and hygiene, especially after using the toilet, is of the most importance, particularly for girls who are more susceptible to E. vermicularis infection. Additionally, it is essential for all family members to be aware of the transmission routes of this parasite.

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Enterobius vermicularis Infection with Tuboovarian Abscess and Peritonitis Occurring during Pregnancy

Abstract: This case was extraordinary because of a combination of tuboovarian abscess and generalized peritonitis with E. vermicularis infection occurring during late pregnancy. Ectopic enterobiasis should be considered in the differential diagnosis of pelvic infections of gynecological origin.

Cited by 33 publications

References 7 publications

Enterobius vermicularis Salpingitis Seen in the Setting of Ectopic Pregnancy in a Malaysian Patient

Enterobius vermicularis Salpingitis Seen in the Setting of Ectopic Pregnancy in a Malaysian Patient

Enterobius vermicularis in a 14-Year-Old Girl's Eye

Vulvovaginitis due to Enterobius vermicularis in a girl and epidemic enterobiasis in her family

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