Pin Worms Presenting as Suspected Crohn's Disease

Area of Science:

• Gastroenterology
• Parasitology
• Internal Medicine

Background:

• Inflammatory bowel disease (IBD) is a significant differential diagnosis for young adults with refractory diarrhea.
• Pinworm infections (Enterobius vermicularis) are less common in adults in developed countries.
• Accurate diagnosis of IBD requires histological confirmation.

Observation:

• A 24-year-old female with autoimmune disorders presented with abdominal pain and was diagnosed with Crohn's disease based on imaging.
• Colonoscopy revealed extensive pinworm presence throughout the colon.
• Colonic biopsies were negative for IBD-related inflammatory changes.

Findings:

• The patient's symptoms and imaging were initially suggestive of Crohn's disease.
• The presence of pinworms in the colon was the primary finding during colonoscopy.
• Histopathological examination of colonic biopsies did not support an IBD diagnosis.

Implications:

• Uncommon parasitic infections can mimic IBD, complicating diagnosis.
• Relying solely on clinical presentation and imaging can lead to misdiagnosis.
• Biopsy confirmation is essential to prevent inappropriate, potentially harmful IBD treatments for conditions like Enterobius infection.