Enterobius Vermicularis (Pin Worm) Causing Symptoms of Appendicitis

An evaluation of the relationship between Enterobius vermicularis infestation and acute appendicitis in a paediatric population – A retrospective cohort study

“…This may be explained by a reporting bias due to the small number of cases of E. vermicularis in our study population however it is 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 known E. vermicularis has a varying geographical incidence and increased immigration and wider access to travel in modern times may also explain this higher observed incidence [10]. The pathophysiology behind the association between E. vermicularis and clinically suspected appendicitis is similar to that associated with a faecolith or luminal lymphoid hyperplasia of the appendix [13]. By obstructing the appendiceal canal it produces colicky right iliac fossa (RIF) pain ("appendiceal colic") but unusually leads to appendiceal inflammation [13,14].…”

“…The pathophysiology behind the association between E. vermicularis and clinically suspected appendicitis is similar to that associated with a faecolith or luminal lymphoid hyperplasia of the appendix [13]. By obstructing the appendiceal canal it produces colicky right iliac fossa (RIF) pain ("appendiceal colic") but unusually leads to appendiceal inflammation [13,14]. It can therefore lead to a clinical scenario mimicking acute appendicitis but not necessarily cause it.…”

Presence of parasitic protozoa and helminth in sewage and efficiency of sewage treatment in Tunisia

“…Enterobius vermicularis 50×20 1.09-1.14 Anal itching (pruritus), usually nocturnal or in the early morning 10.3% in the district of Tunis Ajao et al (1997) Abdominal pain (even mimicking an acute surgical process) 35.8% in the district of Sousse Hugot et al (1999) Irritability Schupf et al (1995) Restlessness Bouratbine et al (2000) in Kenya revealed a minimum retention period of 37.3 days to concentrations of Giardia below detection levels (Grimason et al 1993). Besides, Wiandt et al (1995) did not detect Giardia cysts presence in the summer period by a WSP system having a retention time of 40 days.…”

Enterobius vermicularis and clinical appendicitis: worms in the vermiform appendix

“…Instead, either no tissue reaction or a chronic inflammatory infiltrate of eosinophils is associated 1−3 . While surgery is justified in cases of appendiceal pain 3,4 it should proceed with due caution of this differential and thorough enquiry about patient exposure/symptoms in history taking − especially in children and higher youth age groups.…”

“…Although our case represented mesenteric lymphadenitis, the incidental presence of E. vermicularis in the appendix lumen might have produced the clinical feature of appendiceal pain. Consensus regarding E. vermicularis’ role in appendicitis supports that its mere presence in the appendix can produce symptoms/signs of inflammatory disease independent of histological acute inflammation 1−5 . Appendicitis audits have confirmed infestation 5−10 times more frequently associated with non‐inflamed than acutely inflamed appendices; statistically significant ( P < 0.001) 1−3 .…”