Enterobiasis

Enterobiasis (enterobiosis) is a bot, called round helminth - pinworm (Enterobius vermicularis); length of a male 3-4 mm, females 9-12 mm; parasitizes in the lower half of the small intestines, the caecum and the initial part of the colon. Females pinworms down into the rectum, actively go out of the anus, lay eggs in its circumference and die. Eggs become Mature through 4-6 hours. The life span of worms 3-4 weeks.
Contamination of enterobiasis occurs when ingestion of eggs. You might hit the eggs with dust in the mouth and nose, where they are swallowed with saliva and mucus. Factors of transfer of enterobiasis serve underwear and bed linen of the patient, the seat of the lavatory, potties and other household items. Often there comes a-infection of the patient as a result of pollution eggs pinworms fingers when scratching perianal area.
The clinical picture. The main symptom - perianal itching. As a result of scratches and a secondary bacterial infection may develop dermatitis with very persistent course; sometimes rapid pasty chair; often insomnia, neurasthenic and Psihologicheskii syndromes. Women in the result of zapytania pinworms in sexual crack often vulvovaginitis.
Diagnosis is by detection of eggs pinworms in scrapings from the perianal area or females helminthes on the surface of faeces. The study of feces on eggs of parasites is ineffective, as pinworms in the intestines normally not lay eggs. To make the diagnosis of enterobiasis only on the basis of the patient perianal itching cannot, as it is observed in a number of other diseases: atopic dermatitis, cancer thick guts, candidiasis, chlamydia, and others
Treatment. In mild cases of enterobiasis to cure quite careful observance of purity of the body, clothes, housing, because the life expectancy of pinworms very small. In severe forms of the disease apply piperazine, ether extract of rhizomes male fern, Naftalan.
Piperazine (Piperazinum) assign inwards in 3-5 days, if necessary, a further 1-2 such cycles of treatment with intervals between them 7 days. Single dose piperazine: adults : 1 g; children 1 year - 0.2 g; 2-3 years - 0.3 g; 4-6 years - 0.5 g, 7-9 years - 0.75 g; 10-14 years - 1, In the dose of the drug administered 2 times a day with an interval of 1.5 - 2 hours. Adolescents 15 years of age and adult drug can be assigned to 1 g 3 times a day. Laxative not appointed.
Extract of rhizomes male fern (Extr. Filicis maris aethereum) when enterobiasis is administered in reduced doses: adults - 1.5 g; for children 1-2 years - 0.2 g, 3-4 years - 0.3 g; 5 - 6 years - 0.5 g; 7-8 years - 0.6 g; 9 - 10 years - 0.7 g; 11 - 12 years - 0.9 g; 13-16 years - g Before treatment in the evening - a laxative. The next day on an empty stomach give an extract paporotnika in the reception 1-2; in 1 hour saline laxative. If the patient is not freed from pinworms, 10-12 days to have a second cycle of treatment.
Naftalan (Naphthammonum) appoint on an empty stomach 2 hours before Breakfast. One-time (daytime) dose for adults and children over 5 years - 4-5 g, for children 5 years and younger - 2,5, Drug stir in 50 ml of sugar syrup and gives the patient to drink 1 reception. Treatment is carried out within 1-2 days. If necessary 7-10 days, repeat it.
Prevention. Careful maintaining purity of the body, clothes, dwelling, office and school premises and in the texts. Prophylaxis in children is divided into public and private. Public prevention involves carrying out sanitary activities, explanatory work on the epidemiology of enterobiasis among parents, educators, teachers and all workers of children's institutions. Every child coming to an institution, should be investigated for enterobiasis. All the children and staff of children's institutions should be periodically examined for enterobiasis. Personal prevention measures reduced mainly to prevent the inclusion of eggs pinworms in the human body.
Cm. also Helminthological methods, Nematology.

Enterobiasis (enterobiosis; synonym oxyuriasis) - helminthiasis caused by pinworms and characterized mainly perianal itch, and functional disorders of the nervous system.
Has widespread. Exciter - pinworm Enterobius vermicularis (synonym Oxyuris vermicularis) - round worms white with pointed ends of the body; male length of 2-5 mm, female 8-12 mm, eggs 0,05-0,h,02-0,03 mm, asymmetric, with smooth two-shell. Pinworms are parasites in the lower part of the small intestine, the caecum and the initial part of the ascending colon person. Females go down into the rectum, crawl out from the anus, lay in its circumference eggs and die. The life span of pinworms about 4 weeks. The source of infection - a sick person. Pending in the perianal region eggs Mature in 4-6 hours, that failure to comply with hygiene rules promotes re-infection and infection of others.
Invasive eggs pollute linen, household goods, premises, can get in the subungual space fingers, on food. In the dust of the eggs remain viable for about a month. Dispersion contribute their flies.
The infection occurs when a person swallows invasive eggs with food and water. You might hit the eggs with dust in the mouth and nose, where they are swallowed with saliva and mucus. When enterobiasis easily occurs autorioiguse, which results in long and hard for the disease. Pinworms attach themselves to the lining of the intestines, sometimes embedded in her head part of the body; sometimes they were found in the thickness of the bowel wall. The result can occur point bleeding and erosion, granuloma of epithelioid and giant cells and eosinophils. Mechanical effect, together with sensitization of an organism products of an exchange and the connection of a secondary bacterial infection can lead to inflammation of the mucous membrane ulcers, hypersecretion of mucus, spasm of individual sections of ulcers, allergic phenomena in the form of eosinophilia, itching dermatoses. Females pinworms, penetrating into the female genitals, put bacteria from the gut and cause vulvovaginitis, endometritis, pielotsistit. The zapolzanie pinworms in the process contributes to the occurrence of appendicitis.


The most common complaint of patients enterobiasis - itching in anal region. It occurs normally in the evening and coincides with the release of females pinworms from the anus. Oviposition females combined with local irritation and inflammation that can be amplified as a result of scratches and infection this area. In chronic cases around the anus occurs weeping ackzemopodobne skin lesion with constant persistent itching, redness, swelling, which may be connected with an allergic reaction to the secrets of pinworms and sticky substance shells of their eggs. Often cramping abdominal pain, frequent stools with mucus, tenesmus. Sigmoidoscopy reveals increased exudation mucous, dotted haemorrhage, erosion, increased vascular pattern, irritation of mucous membranes in the field of sphincters. Frequent symptom - irritability caused by itching and lack of proper sleep. This is manifested by motor concern in his sleep, insomnia, headaches, dizziness, fatigue, loss of appetite and weight. Children may experience seizures, gnashing of teeth, scratching his nose distraction, inattention, anxiety, bedwetting. Girls itching and zapytanie pinworms in the genitals can lead to Masturbation and vulvovaginitis. In adults enterobiasis sometimes occurs without obvious clinical symptoms. Such persons are particularly dangerous to others.
Diagnosis is easily when having itching anus, detection
pinworms and their eggs scrapings with perianal folds (see Helminthological methods, research). Perianal itch, however, may be a consequence of hemorrhoids, persistent constipation, proctitis and sincerita, contact dermatitis, psoriasis, neurodermite and eczema perianal area, colon cancer, Trichomonas vaginitis, menopause, candidiasis, diabetes mellitus, hyperthyroidism, thyroid prostate cancer, Hodgkin's disease, strongiloidoz, ascariasis, trichocephalosis, diseases of the liver and kidneys.
Treatment of enterobiasis achieves the purpose of respecting personal prophylaxis and simultaneous treatment of all infected family members, and children groups - all infested children and staff. To prevent Eutonazia it is recommended to wear tight-fitting body pants or leggings with elastic, Ironing their clothes together with linen in the morning with a hot iron over 1.5 months. To combat the itching and to mechanical removal of pinworms recommended to insert the night in the anus wool, do enemas (adults from 5 cups, children from 1-3 cups of water), in the morning, wash anal area with warm water. When a persistent itch - lubrication itchy spots of the ointment with benzocaine or prednisolone, the appointment of the interior of Dimedrol and drug enemas (from 1% solution novokaina 30 ml on enema of 0.4% solution of colloid 50 ml on enema 2 times a day; only 20 enemas). Deworming carried drugs piperazine and Saptamona. The course of treatment piperazine consists of 1-3 five-day cycles with between 7 days. Daily dose for children 1 year - 0.4 g; in 2-3 years-0.6 g; 4-6 years-1 g, 7-9 years of 1.5 g; 10-14 years, 2 g; 15 and over-2-3 g; daily dose is 2 to 3 admission. Naftalan prescribed in sugar syrup 1 per day on an empty stomach 2-2,5 g of children under 5 years and 4-5 g children older than 5 years and adults. The cycle of treatment is 3 days.
Prevention. Sanitary-and-hygienic actions in houses, institutions, enterprises.