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Enterobius vermicularis (pinworm) infestation mimicking acute appendicitis in two children from Palestine: a case
Issam Jawabreh1, Ahmad Amro2, Kifaya Azmi1,3
1Faculty of Medicine, Al-Quds University, Jerusalem, Palestine.
Insights
Pinworm (Enterobius vermicularis) infection can mimic appendicitis in children, posing diagnostic challenges. Early identification and treatment with anthelmintics are key to preventing complications and unnecessary surgery.
Area of Science:
- Pediatric Infectious Diseases
- Gastrointestinal Pathology
Background:
- Pinworm (Enterobius vermicularis) infections are prevalent in children, particularly in regions like Palestine.
- While typically benign, pinworm infestations can rarely lead to severe complications, including acute appendicitis.
Observation:
- Two pediatric cases of acute appendicitis in Palestinian children were investigated.
- Appendectomy revealed Enterobius vermicularis eggs and adult worms, confirming parasitic infestation as the cause.
Findings:
- Pathological examination confirmed appendicitis secondary to pinworm infestation in both cases.
- Post-operative anthelmintic treatment led to successful recovery without complications.
Implications:
- Clinicians should consider Enterobius vermicularis infestation in pediatric patients presenting with abdominal pain suggestive of appendicitis.
- Prompt diagnosis and appropriate anthelmintic therapy can prevent misdiagnosis, unnecessary surgical interventions, and potential peritoneal contamination.
Background:
Pinworm, Enterobius vermicularis, is a common parasitic illness, particularly among children in Palestine. On rare occasions, it can cause serious consequences such as acute appendicitis, which can still present a challenging diagnosis especially in children.
Case Presentation:
This report describes two cases (a 9 year old male and a 11 year old female, both Palestinian children from Hebron district) of acute appendicitis referred to Queen Alia Hebron Governmental Hospital in Palestine. The clinical examination revealed a lower abdominal pain, and they were diagnosed with appendicitis. The pathological examination after appendectomy showed the presence of eggs and pinworms. Anthelminthic medication was provided, and they were followed up for 6 weeks after the operation without any incidents.
Conclusion:
These cases highlight the importance of considering Enterobius vermicularis infestation in children with abdominal pain, as the parasites can mimic appendicitis. Prompt recognition and cautious laparoscopic appendectomy are crucial to prevent unnecessary surgery and peritoneal contamination, with the infestation being easily treatable with anthelmintic medication.
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