[Infestation with Enterobius vermicularis mimicking appendicitis].

Abstract

BACKGROUND:

Gastrointestinal infestation with the parasite Enterobius vermicularis is common in humans and is usually harmless. Anal pruritus is the most characteristic symptom, but the parasites can cause severe abdominal pain mimicking appendicitis. Early recognition can prevent an unnecessary appendectomy.

CASE DESCRIPTION:

A six-year-old girl reported to the accident and emergency department with pain in the lower right abdominal region. She was admitted and treated for suspected perforated appendix, following physical examination supplemented with an abdominal CT scan. After antibiotic treatment the symptoms disappeared as did the abscess, apart from a minor amount of residual infiltrate. She was then readmitted twice with recurrent abdominal pain without radiological evidence of an abdominal focus. We decided to conduct a diagnostic laparoscopy and an elective appendectomy à froid. During this procedure living worms were found in the appendix. Treatment with the anthelminthicum mebendazol was effective.

CONCLUSION:

Gastro-intestinal infestation with E. vermicularis is very common, especially in young children. This infestation is usually harmless, but can mimic appendicitis. This infestation is easily treatable with mebendazol.

• Authors: Afra M A Levens, Maarten Schurink, Harma A Koetse, Robertine van Baren
• Journal: Nederlands tijdschrift voor geneeskunde (Ned Tijdschr Geneeskd) Vol. 158 Pg. A7371 ( 2014) ISSN: 1876-8784 [Electronic] Netherlands
• Vernacular Title: Appendicitis-beeld door Enterobius vermicularis.
• PMID: 25424628 (Publication Type: Case Reports, Journal Article)

Chemical References

• Antinematodal Agents
• Mebendazole

Topics

• Abdominal Pain (diagnosis, parasitology)
• Animals
• Antinematodal Agents (therapeutic use)
• Appendicitis (diagnosis)
• Child
• Communicable Diseases
• Diagnosis, Differential
• Enterobiasis (diagnosis, drug therapy)
• Enterobius (isolation & purification)
• Female
• Humans
• Laparoscopy
• Mebendazole (therapeutic use)
• Treatment Outcome