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Oxyuriasis: treatment, symptoms

by Josephine Andrews
Published: Last Updated on 355 views

The pinworm (Enterobius vermicularis) is the causative agent of oxyuriasis , which occurs worldwide. It occurs mainly in small children and is transmitted from person to person, particularly through poor hygiene. Those affected usually do not even know that they have been infected. Oxyuriasis is easy to treat. Read more about oxyurosis here.

ICD codes for this disease: B80

ICD codes are internationally valid codes for medical diagnoses. They can be found, for example, in doctor’s letters or on certificates of incapacity for work.

quick overview

  • Treatment: In particular, good hygiene, washing hands, cleaning contaminated objects; Vermifuge as medication for the sufferer and household members
  • Symptoms: nocturnal itching on the anus; possibly worms in the stool; rarely complications such as intestinal or appendicitis; possibly inflammation of the vagina in case of infestation
  • Cause and risk factors: infestation with pinworms; fecal-oral transmission due to poor hygiene, especially in children; inhaling the eggs when making the bed; intercourse
  • Diagnosis: Based on the symptoms; possibly blood test; Microscopic evaluation of an adhesive strip that is stuck to the anal region in the morning
  • Prognosis: Usually harmless, often asymptomatic infection; only rarely complications such as inflammation of the intestine or vagina; good claim to treatment; with good hygiene without self-reinfection often heals by itself
  • Prevention: good hygiene, washing hands after going to the toilet and before preparing food; clean potentially contaminated items

What is oxyurosis?

Oxyuriasis is caused by infection with the pinworm. Some doctors refer to the infection with the intestinal parasites as enterobiosis. The name is based on the Latin name of the worm: Enterobius vermicularis.

Parasitic diseases are usually rare in Germany and often a souvenir from the tropics. An exception is oxyuriasis, which is also common in industrialized countries such as Germany, Austria and Switzerland. Approximately 400 million people worldwide are infected with pinworms.

How can oxyurosis be treated?

If an infestation with pinworms has been detected or if an infection is suspected, it is advisable to observe a few points in order to get rid of the parasite infestation as quickly as possible. In order to avoid immediate reinfection, ie a recurring infection, it is necessary to take some hygiene measures. At the same time, the doctors administer medication to kill the worms in the intestine.

Hygienic measures for oxyuriasis (enterobiasis)

In order to avoid further spread and reinfection, those affected should ideally observe the following instructions, in which cell phonegia is particularly important:

  • Thorough hand washing after using the toilet and before contact with food
  • Only disinfectants containing chlorhexidine effectively kill the eggs. However, thorough hand washing is usually sufficient.
  • Wash underwear, pajamas and bedding with boiled linen
  • Change underwear every night
  • Tight underpants during the night prevent unconscious scratching.
  • For anal itching, apply special cream before bedtime (the doctor will advise)
  • Cleaning toys and possible contaminated items with hot water
  • Keep fingernails short
  • Cleaning agents containing biguanide and phenol are suitable for surface cleaning.
  • Household vacuum cleaners only distribute the eggs.

Cleaning cuddly toys in the washing machine, possibly with a hygiene detergent, makes more sense than freezing them. Freezing doesn’t necessarily kill the eggs, but washing them removes them.

Drugs for oxyuriasis (enterobiasis)

The treatment of oxyuriasis is very simple. A single tablet is usually enough to kill the pinworms in the intestine. Since reinfections are common, the therapy should be repeated after 14 days. All infected persons should start drug therapy at the same time to avoid repeated cross-infection.

People living close by, such as family members in the same household, are often treated as a precaution. There are several drugs that successfully kill pinworms. This group of substances is called antihelmintics. The two most commonly used active ingredients are:

  • mebendazole
  • pyrantel

If the vagina is infected, doctors recommend the vermifuge albendazole, which is most likely taken as a tablet and also has a systemic effect throughout the body.

In consultation with the doctor, these medications can usually also be used during an existing pregnancy.

Home remedies for pinworms

In addition to the effective medicines and hygiene measures, some home remedies are described that should help to get rid of a pinworm infestation quickly. These include:

  • sauerkraut juice
  • Raw sauerkraut
  • raw carrots
  • black seed oil
  • pineapple
  • papaya

The effect may be due to the increased intestinal activity caused by these foods, which are intended to help transport the pathogens out of the intestine. Pineapple and papaya also have special enzymes that may attack the worms. However, these home remedies are mainly effective against an infestation in the intestine and not in the vagina.

Other home remedies including garlic , thyme or pumpkin seeds should also help.

Home remedies have their limits. If the symptoms persist over a longer period of time, do not get better or even get worse, you should always consult a doctor.

What are the symptoms?

Pinworms (Enterobius vermicularis) often go unnoticed for a long time because there are no symptoms. The most common and specific symptom of oxyuriasis is itching of the anus and vagina. Since the female worms usually emerge from the anus at night to distribute their eggs in the skin folds of the surrounding skin, the itching is particularly annoying at night. Small worms are sometimes discovered when inspecting the stool or panties. The patient usually visits the doctor for these two reasons.

Behavioral or developmental disorders are sometimes noticed in young children. Because of the itching, sleep disturbances sometimes occur indirectly.

In girls and women, there is a risk that the worm will infect the vagina and trigger an inflammatory reaction there, possibly with a discharge.

If the infestation is very severe, inflammatory processes in the intestinal wall rarely occur. In some cases, such processes result in appendicitis or a perforated (burst) intestine. If one does not react quickly in such situations, the patient’s life is in acute danger.

As a rule, however, enterobiosis or oxyuriasis is a harmless disease and complications are very rare.

Causes and risk factors

Pinworms are more common in babies and children, but sometimes also in adults. Women are generally more affected than men. Pinworms are small thread-like parasites that belong to the nematodes (roundworms).

As parasites, they belong to the living beings that live in another organism (for example in humans) and feed themselves at its expense. The pinworm only affects humans. The adult worms live in the large intestine, where they develop from larvae into adult worms.

The male is about half a millimeter, the female up to 1.5 centimeters. After fertilization, the female migrates to the anus and lays up to 10,000 eggs in the folds of skin just around the anus, preferably at night. This creates an itch. Due to the sometimes unconscious scratching during sleep, the eggs quickly get on the hands and under the fingernails of the infected person. If the contaminated fingers are put in the mouth, self-infection is possible.

In addition, the eggs are transferred to objects during the preparation of food or through hand contact. Since the eggs remain infectious for up to three weeks in a moist environment, re-infection from remaining eggs is possible even after successful treatment. At body temperature, the worms begin their larval development in the freshly laid eggs after just a few hours. After five to six weeks, the worms are sexually mature and start producing eggs.

Oxyuriasis is primarily transmitted through hand contact. An important risk factor is therefore poor hygiene and careless hand washing. Since the infection occurs mainly in young children, the risk of oxyurosis infection in day care centers or crèches is higher than at home.

The parasite can also be transmitted during sexual intercourse. Anal-oral practices in particular allow infection.

investigations and diagnosis

For the doctor, anal itching is often the first sign of a possible oxyurosis infection. The first point of contact is usually the family doctor. The doctor will first question the patient in detail. He asks questions like:

  • When does the itch appear?
  • Have you observed white worms in the stool or anus?

A blood test often gives further indications of a pinworm infestation. There are increased numbers of immune cells that specifically fight against parasites, so-called eosinophils. If their number is increased, one speaks of eosinophilia.

However, the best method is to microscopically identify the eggs early in the morning, before cleaning or defecation. This is usually done with a clear adhesive film that is stuck to the skin around the anus. The adhesive strip is carefully removed and placed on a slide. The eggs can be detected directly using a microscope.

In some cases, especially when the infestation is severe, you can already see the small white worms on the stool. If the worms escape to the outside world, they die quickly. However, they can sometimes still be seen alive in the excreted stool. The females in particular stay close to the anus. They can be recognized by their white, threadlike shape and whip-like movements.

Course of the disease and prognosis

Oxyuriasis is usually harmless. Complications rarely occur. It is common for children to reinfect themselves the same night. Finger/thumb sucking takes the eggs straight from the anus to the mouth. However, this usually does not pose a major risk to the health of the child.

The therapy is very well tolerated and side effects only occur in very few cases. Here, too, complications are rare.

If the infestation is severe, the intestinal function may be restricted. Inflammation or perforation are then possible. These potentially life-threatening courses are very rare and are associated with stool retention or abdominal pain.

In women, it sometimes happens that the worm eggs get into the vagina and develop there. This triggers an inflammatory response that may be associated with pain and possible discharge.

If there is no self-infection by ingesting the eggs with good hygiene, the worms have often disappeared from the intestine by themselves after two to three weeks when their life cycle is over.

prevention

Above all, good hygiene, such as washing your hands especially after using the toilet and before preparing food, helps to prevent infection — or re-infection.

Changing underwear daily, trimming fingernails, and washing up potentially contaminated toys and objects (especially if other children are handling them) also help.

However, complete avoidance is difficult because infection with pinworms is very easy. Some people are already infected by inhaling the eggs when the bed is shaken out. Experts assume that up to 500 million people worldwide are infected every year and that practically every second person is affected by oxyuriasis at least once in their life.

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