Pinworms: The Daily PANCE Blueprint

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Pinworms: The Daily PANCE Blueprint

A 5-year-old is brought to you by her mother with a complaint of perianal itching which occurs mostly at night. It affects her sleep and makes her restless. Which of the following would not help to confirm the diagnosis in this patient?

A. Stool for parasites
B. Cellophane-tape test
C. Serologic test
D. Nocturnal examination of the perianal area

Answer and topic summary

The answer is C. Serologic test 

A serologic test CAN NOT be used to diagnose pinworm

  • A. Stool for parasites: Stool can be grossly examined for adult worms. Ova are rarely seen in the stool
  • B. Cellophane-tape test: Most commonly used. Cellophane tape is applied to the perianal skin, ideally in the early morning to collect eggs for microscopic examination. The sensitivity of the tape test is reported to be about 50% for a single test and 90% for three tests
  • D. Nocturnal examination of the perianal area is also done to identify adult worms
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Pearls

Pinworm infection, also known as enterobiasis vermicularis, is a human parasitic disease caused by the pinworm (a type of roundworm). The most common symptom is itching in the anal area. This can make sleeping difficult.

  • Perianal itching especially at night (eggs are laid at night)
  • The disease is spread among people by pinworm eggs. As a patient itches the anal area where the eggs are located, the eggs cling to the fingers and can easily be transmitted to other people either directly or through food or surfaces. The eggs can thrive for 2-3 weeks on an inanimate object.

Diagnosis

Diagnosis is with a “scotch tape test’ done in the early morning

Treatment

Pinworms can be effectively treated, but serious complications can develop if the infestation is severe.

  • Anti-parasitic medications are given to kill the pinworms and their larvae.
  • Treatment is with albendazole or mebendazole
  • The entire family should be treated because pinworms are so contagious.

Smarty PANCE Content Blueprint Review:

Covered under ⇒ PANCE Blueprint Infectious Disease (6%) ⇒ Parasitic Disease (PEARLS) ⇒ Pinworms (Lecture)