​Kembara Xtra - Medicine - Pinworms

​Kembara Xtra - Medicine - Pinworms
gastrointestinal; skin/exocrine systems are impacted. Enterobius vermicularis infection of the intestines is characterized by perineal and perianal itching, which is typically worst at night. 

Epidemiology 
Age range most common: 5 to 14 years
Prevalence
The parasite is carried by 20 to 42 million Americans, or 30% of all children globally, who have helminthic infections.

Child Safety Considerations
more prevalent in children, who are also more likely to relapse 

Pathophysiology and Etiology 
Following ingestion, the cecum, appendix, and surrounding regions of the ascending colon are inhabited by tiny white worms (2 to 13 mm).
In order to lay their eggs, female worms travel at night to the perineal regions, causing localized discomfort and itching. Scratching results in the autoingestion of the eggs and the continuation of the pinworm's life cycle within the host. Eggs spend one to two months in the host's small intestine incubating. When fully grown, female pinworms move to the colon, where they spend the nighttime laying eggs near the anus.
 E. vermicularis, an intestinal nematode, infestation

Risk factors include handling contaminated children's clothing or bedding, living in cramped quarters with poor hygiene, institutionalization (prevalence exceeding 50%), and a warm environment.

Prevention 

 Hand washing, especially after using the restroom  Keep your fingernails short and clipped.
 At least once a day, preferably in the shower, wash your anus and genitalia.
Avoid rubbing your nose or mouth with your fingers because pinworm eggs might be inhaled.

Related Illnesses Pruritus ani


Diagnosis 
There are many asymptomatic patients. The following are typical signs:  Vulvovaginitis Dysuria Abdominal pain (rare) Insomnia (usually brought on by pruritus) Perianal or perineal itching MEDICAL ANALYSIS
Examine your perineum and perianal region, especially in the morning, to check for signs of worm migration. 

Idiopathic pruritus ani, atopic dermatitis, contact dermatitis, psoriasis, lichen planus, human papillomavirus (HPV), herpes simplex virus (HSV), fungi, and erythrasma are among the differential diagnoses. Hemorrhoids, Chron disease, ulcerative colitis, scabies, vaginitis, and

Laboratory Results 

Adhesive tape test: To check for pinworm eggs, apply cellophane tape to the perianal region in the early morning before taking a bath.
- 90% sensitivity if three mornings in a row are used. Use anal swabs or a pinworm paddle covered in adhesive substance as an alternative. Pinworm eggs can be found in scrapings from under the fingernails of those who are afflicted.
 Digital rectal examination and saline finger preparation of the stool Samples from the feces are useless.
Only 10% to 15% of infected patients have positive results from routine stool testing for ova and parasites.
Initial examinations (lab, imaging)
Pinworm infections cannot yet be diagnosed by serologic assays.
Test interpretation involves either direct observation of the female worm (10 mm long) or identification of the ova using low-power microscopy; the ova are asymmetric, flat on one side, and measure 56 27 m.

First Line of Medicine
Treatment choices comprise:
- Albendazole (Albenza): For adults and children >20 kg, a single dosage of 400 mg PO may be repeated in 2 weeks; for children 20 kg, a single dose of 200 mg PO may be repeated in 2 weeks. - Mebendazole (Emverm, Vermox): Use with caution in children under 2 years of age. Chewable 100-mg tablets should be taken as a single dose in adults and children over 2 years of age.
- Pyrantel pamoate (Pin-X, Reese Pinworm Medicine): orally administered as a liquid or tablet at a dose of 11 mg/kg for adults and children older than 2 years; the maximum dose is 1 g. Use with caution in kids under 2 years old.
● Due to the high likelihood of reinfection, repeat therapy after two weeks is frequently advised. Retreatment every two weeks for four to six cycles may be necessary in refractory instances (occasionally).
All family members who exhibit symptoms need to be treated.


pregnant women's issues

pregnant Category C medicines are all three, thus avoid pharmacological therapy throughout pregnant. Treat after delivery, but if the infection is endangering the pregnancy, you might want to consider treating in the third trimester. Breastfeeding is permitted when receiving mebendazole treatment.


Take Action 

Unless symptoms return after initial treatment, not necessary

Take your medication with food, as per patient education.
 Wash your hands frequently and take care of your perianal hygiene, especially after using the restroom. Encourage regular, thorough hand washing.
 Trim your fingernails.
After receiving a diagnosis, wash your clothes and mattress to prevent reinfection. Before laundering, avoid shaking bed linens and clothing as this could spread the eggs.
You shouldn't swap washcloths.
Children should take showers instead of swimming throughout treatment and for two weeks afterward.

Reinfection is frequent, particularly in children. Drug therapy is 90% curative. Asymptomatic carriers are frequently found.


Complications Scratching the perianal area could result in a bacterial superinfection.
Females: salpingitis, vulvovaginitis, urethritis, and endometritisUTIs Infrequently: colonic intussusception; ectopic illness with granulomas of the pelvic, genitourinary tract, and appendix.

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