Pinworms Flashcards
pinworms is an intestinal infection with ___________
enterobius vermicularis
enterobius vermicularis is a
parasitic helminth
what is the msot comon helminth infection in Canada
pinworms
on average, how many pinworms does an infected person have
severe to several hundreds
pinworms are most common in children ______ and uncommon ______
5-14yrs
uncommon <2yrs
which of the following is false
1. there is a higher incidence of pinworms in crowded living conditions
2. 1/3 canadian children will develop pinworms in childhood
3. pinworms are most commonly found in children <2yrs
4. an adult female worm is 2-5mm long
5. 3 and 4
5
describe the 5 steps of pinworm transmission
Eggs deposited in perianal folds
Infected individual scratches around the anus and touches another person or object
Uninfected person puts contaminated hand/ object into mouth and swallows eggs
Larvae hatch in small intestine and adults reside in colon
At night, female worm migrates to perianal region to lay eggs
what is the most common sx of pinworms + other sx?
pruritus ani - esp at night
disrupted sleep, restlessness and irritability
loss of appetite
what are some complications of pinworms
Generally just a nuisance but may spread to other organs = infection, appendicitis, other related complications
Migration to vaginal area = irritation, discharge, urinary incontinence
Severe perianal scratching may lead to bacterial infections
2 diagnostics for pinworms
flashlight test
scotch tape test
how would you do the flashlight test
may see thread like worm at night with flashlight
Can place worms in alcohol or vinegar and bring to clinic for confirmation
how would you perform the scotch tape test
Perform at home in the morning before defecation or showering
Piece of transparent adhesive tape pressed on perianal skin- then stuck to a slide to be examined under microscope
May have to repeat several times
1 examination will confirm diagnosis in 50% of cases, 3 exams = 90%, 5 exams = 99%
what education should you provide parents about pinworms
not caused by uncleanliness
best to avoid prophylactic tx
treat everyone in the household >2yrs
list 3 nonpharm ways to treat pinworms
Meticulous hand washing after defecation and before eating
Keep fingernails cut short + discourage scratching
Change underwear, pajamas, and bed linens daily
Wash underwear, pajamas, and hand towels daily in hot water for 2 weeks
Shower in the morning so eggs laid the previous night will be washed away
Frequent washing of toilet seat
Clean the floors and vacuum all areas of bedroom
pts may use a _______ to relieve itching from pinworms
zinc oxide preparation
what are 2 pharm tx for pinworms
pyrantel pamoate
mebendazole
combatrin
- cure rate: __________
- single dose of _________ and repeat in _______
90-100%
11mg/kg (max 1g) and repeat in 2 wks
pyrantel pamoate MOA
Paralyzes adult worm = prevents from attaching to GI wall
when using combatrin, exercise caution with
1. liver dysfunction
2 .blood disorders
3. SJS
4. none of the above
1
combatrin has _________ systemic absorption
little
mebendazole cure rate
100%
mebendazole is a single dose of _________ in ________ and repeat in ____________
100mg in adults and children =>2yrs
repeat in 2 wks
MOA of mebendazole
inhibits worm glucose absorption
mebendazole SEs
GI (N/V/D)
rare: derm (SJS), blood dyscrasias
pinworm medication only kills ________, leaving ________ unaffected
adult worms
eggs and larvae
pinworm ova floating in air can cause reinfection for ___
2wks
why is it important to retreat for pinworms after 2 wks
cause the meds only kill adult worms- not eggs and larvae
for pinworm tx in pregnancy
1. should be avoided in first trimester
2. should be avoided if pt asymptomatic as it will not cause harm to mother or child
3. should treat if symptomatic and natural cure unlikely
4. should treat if symptomatic with combatrin or mebendazole in 2nd trimester or later
5. all of the following is true
5
itching from pinworms should resolve in _______ of starting treatment. if not, _________
7-14 days
repeat tx
if itching from pinworms doesn’t resolve within ______ of 2nd course = refer
7 days
why is there a very high likelihood of being reinfected with pinworms
Scratching
Not properly washing of hands after scratching or using washroom
Exposure to infected soils, dust, clothing, etc
Meds only kill adult worms
