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Recurrent paediatric pinworm infection of the vagina as a potential reservoir for Enterobius vermicularis

Published online by Cambridge University Press:  31 May 2013

B. Kashyap*
Affiliation:
Department of Microbiology, UCMS (University College of Medical Sciences) & GTB (Guru Teg Bahadur) Hospital, Delhi, India
J.C. Samantray
Affiliation:
Department of Microbiology, AIIMS (All India Institute of Medical Sciences), New Delhi, India
S. Kumar
Affiliation:
IPP (India Population Project) VIII, MCD (Municipal Corporation of Delhi), Delhi, India
R. Jhamb
Affiliation:
Department of Medicine, UCMS (University College of Medical Sciences) and GTB (Guru Teg Bahadur) Hospital, Delhi, India
A.K. Singh
Affiliation:
Department of Microbiology, UCMS (University College of Medical Sciences) & GTB (Guru Teg Bahadur) Hospital, Delhi, India
I.R. Kaur
Affiliation:
Department of Microbiology, UCMS (University College of Medical Sciences) & GTB (Guru Teg Bahadur) Hospital, Delhi, India

Abstract

Enterobius vermicularis infection remains one of the most common parasitic infections, particularly prevalent in children. Enterobiasis, although not usually dangerous, may cause significant morbidity. Elimination of the parasite from a family or an institution often poses problems, either because of an incomplete cure or re-infection. While there have been limited reports of ectopic enterobiasis throughout the world, ours is probably one of the rarest reports of recurrent vaginal E. vermicularis infection in the absence of any gastrointestinal symptoms despite complete treatment. A 4-year-old girl presented with recurrent episodes of vulval itching on 3–4 occasions over 2 years. There was no pruritis ani nor urinary/gastrointestinal complaints. The vulva was inflamed with 4–5 living worms, 6–7 mm in length, emerging from the anterior vaginal fornix, but with no vaginal discharge. Direct microscopic examination of vaginal swabs revealed adult worms of Enterobius but no eggs. Repeated stool samples from the patient, parents and a sibling were negative. The patient was treated orally with 100 mg of mebendazole for 3 days followed by two more courses at 3-week intervals over a period of 3 months. Recurrent vaginal enterobiasis despite complete treatment and in the absence of any gastrointestinal involvement suggests that the vagina is a potential reservoir for E. vermicularis, which supports the theory of rare ectopic enterobiasis through the ascending pathway of the female genital tract.

Type
New Concepts and Case Studies
Copyright
Copyright © Cambridge University Press 2013 

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