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| | align="center" style="background:#DCDCDC;" |Perianal carcinoma (Bowen disease) | | | align="center" style="background:#DCDCDC;" |Perianal carcinoma (Bowen disease) |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" | | | | style="padding: 5px 5px; background: #F5F5F5;" align="left" | |
| * Mental status changes ([[anxiety]], agitated [[delirium]], [[restlessness]], and [[disorientation]]) | | * |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |Elevated [[Creatine kinase|CK]], [[Lactate dehydrogenase|LDH]], [[Alkaline phosphatase|ALP]], [[Aspartate transaminase|AST]], and [[Alanine transaminase|ALT]] | | | style="padding: 5px 5px; background: #F5F5F5;" align="left" | |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |History of recent use of [[Selective serotonin reuptake inhibitor|SSRIs]], [[Serotonin-norepinephrine reuptake inhibitor|SNRIs]] , or [[Monoamine oxidase inhibitor|MAOIs]]. | | | style="padding: 5px 5px; background: #F5F5F5;" align="left" | |
| |- | | |- |
| | rowspan="3" style="background:#4479BA; color: #FFFFFF;" ! |Hygiene | | | rowspan="3" style="background:#4479BA; color: #FFFFFF;" ! |Hygiene |
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| | align="center" style="background:#DCDCDC;" |Excessive sweating and Poor cleaning | | | align="center" style="background:#DCDCDC;" |Excessive sweating and Poor cleaning |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" | | | | style="padding: 5px 5px; background: #F5F5F5;" align="left" | |
| * Mental status changes ([[anxiety]], agitated [[delirium]], [[restlessness]], and [[disorientation]]) | | * |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |Elevated [[Creatine kinase|CK]], [[Lactate dehydrogenase|LDH]], [[Alkaline phosphatase|ALP]], [[Aspartate transaminase|AST]], and [[Alanine transaminase|ALT]] | | | style="padding: 5px 5px; background: #F5F5F5;" align="left" | |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |History of recent use of [[Selective serotonin reuptake inhibitor|SSRIs]], [[Serotonin-norepinephrine reuptake inhibitor|SNRIs]] , or [[Monoamine oxidase inhibitor|MAOIs]]. | | | style="padding: 5px 5px; background: #F5F5F5;" align="left" | |
| |- | | |- |
| | align="center" style="background:#DCDCDC;" |Meticulous cleansing of anal area | | | align="center" style="background:#DCDCDC;" |Meticulous cleansing of anal area |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" | | | | style="padding: 5px 5px; background: #F5F5F5;" align="left" | |
| * Mental status changes ([[anxiety]], agitated [[delirium]], [[restlessness]], and [[disorientation]]) | | * |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |Elevated [[Creatine kinase|CK]], [[Lactate dehydrogenase|LDH]], [[Alkaline phosphatase|ALP]], [[Aspartate transaminase|AST]], and [[Alanine transaminase|ALT]] | | | style="padding: 5px 5px; background: #F5F5F5;" align="left" | |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |History of recent use of [[Selective serotonin reuptake inhibitor|SSRIs]], [[Serotonin-norepinephrine reuptake inhibitor|SNRIs]] , or [[Monoamine oxidase inhibitor|MAOIs]]. | | | style="padding: 5px 5px; background: #F5F5F5;" align="left" | |
| |- | | |- |
| | align="center" style="background:#DCDCDC;" |Skin irritants | | | align="center" style="background:#DCDCDC;" |Skin irritants |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" | | | | style="padding: 5px 5px; background: #F5F5F5;" align="left" | |
| * Mental status changes ([[anxiety]], agitated [[delirium]], [[restlessness]], and [[disorientation]]) | | * |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |Elevated [[Creatine kinase|CK]], [[Lactate dehydrogenase|LDH]], [[Alkaline phosphatase|ALP]], [[Aspartate transaminase|AST]], and [[Alanine transaminase|ALT]] | | | style="padding: 5px 5px; background: #F5F5F5;" align="left" | |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |History of recent use of [[Selective serotonin reuptake inhibitor|SSRIs]], [[Serotonin-norepinephrine reuptake inhibitor|SNRIs]] , or [[Monoamine oxidase inhibitor|MAOIs]]. | | | style="padding: 5px 5px; background: #F5F5F5;" align="left" | |
|
| |
|
| |} | | |} |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Furqan M M. M.B.B.S[2]
Overview
Enterobiasis must be differentiated from other nematode infections.
Differentiating Enterobiasis from other diseases
Causes
|
Signs and symptoms
|
Diagnostic approach
|
Treatment
|
Anorectal
Disorders
|
Inflammatory bowel disease
|
- Abdominal pain
- Diarrhea (secretory, mucoid,or bloody)
- Weight loss
- Perianal pruritis
|
- Physical examination
- Antinuclear antibodies
- Sigmoidoscopy/colonoscopy
|
- Sulfasalazine, mesalamine.
- Oral steroids.
- Antibiotics (e.g, metronidiazole).
- Azathioprine, 6-mercaptopurine.
- Infliximab, adalimumab, etc.
|
Hemorrhoids(internal or external)
|
- Bright red blood on toilet paper/stool.
- Pain with defecation.
- Painful lump in the anal area.
- Perianal pruritis
|
- Physical examination
- Anoscopy/sigmoidoscopy
|
- Psyllium, methylcellulose.
- Surgery.
|
Anal fissure
|
- Bright red blood on toilet paper/stool.
- Pain with defecation.
- Perianal pruritus.
- Anal tears
|
- Physical examination reveals anal lacerations
|
- Topical anesthetics.
- Psyllium, methycellulose.
|
Skin
infections
|
Bacterial
|
- Skin edema, erythema, and warmth.
- Pruritis, pain, and discharge from the lesions.
|
- Physical examination reveals local inflammatory findings.
- Culture/sensitivity of discharge
|
- Topical or oral antibiotics.
|
Candidal
|
- Erythematous skin plaques and erosions with peripheral scaling.
- Pruritus on the skin plaques.
|
- KOH preparation of skin scrappings
|
|
Scabies
|
- Erythematous papules with hemorrhagic crustings.
- Pruritus, pain, and bleeding from papules.
|
- Identification of eggs on skin scrapings.
|
- Topical permethrin.
- Oral ivermectin.
|
HPV
(Condylomata
acuminata)
|
- Soft papules/plaques in the anogenital area.
- Pruritus, pain, and bleeding from papules.
|
- Physical examination.
- Shave biopsy of the lesion.
|
- Topical trichloroacetic acid.
- Topical imiquimod.
- Cryotherapy or surgical resection.
|
Skin disorders
|
Atopic dermatitis
|
- Erythematous, pruritic, scaly skin lesions.
|
|
- Topical emollients.
- Topical steroids.
|
Seborrheic dermatitis
|
- Erythematous, yellow, oily plaques.
- Mild pruritus.
|
|
- Topical emollients.
- Topical steroids.
- Topical ketoconazole.
|
Contact dermatitis
|
- Erythematous, pruritic skin lesion.
|
|
- Avoid irritants.
- Topical steroids.
|
Lichen planus
|
- Pruritic, purple, polygonal plaques or papules.
|
- Physical examination.
- Punch/shave biopsy
|
- Topical steroids.
- Phototherapy.
|
Lichen sclerosis
|
|
Elevated CK, LDH, ALP, AST, and ALT
|
History of recent use of SSRIs, SNRIs , or MAOIs.
|
Perianal carcinoma (Bowen disease)
|
|
|
|
Hygiene
Related problems
|
Excessive sweating and Poor cleaning
|
|
|
|
Meticulous cleansing of anal area
|
|
|
|
Skin irritants
|
|
|
|
The table below summarizes the findings that differentiate enterobiasis from other nematode infections.
Differentiating Enterobiasis from other Nematode infections[1][2]
|
Nematode
|
Transmission
|
Direct Person-Person Transmission
|
Duration of Infection
|
Pulmonary Manifestation
|
Location of Adult worm(s)
|
Treatment
|
Ascaris lumbricoides
|
Ingestion of infective ova
|
No
|
1-2 years
|
|
Free in the lumen of the small bowel
(primarily jejunum)
|
|
Trichuris trichiura
(whipworm)
|
Ingestion of infective ova
|
No
|
1-3 years
|
No pulmonary migration, therefore, no pulmonary manifestation
|
Anchored in the superficial mucosa of cecum and colon
|
|
Hookworm (Necator americanus and Ancylostoma duodenale)
|
Skin penetration by filariform larvae
|
No
|
- 3-5 years (Necator)
- 1 year (Ancylostoma)
|
|
Attached to the mucosa of mid-upper portion of the small bowel
|
|
Strongyloides stercoralis
|
Filariform larvae penetrates skin or bowel mucosa
|
Yes
|
Lifetime of the host
|
|
Embedded in the mucosa of the duodenum, jejunum
|
|
Enterobius vermicularis (pinworm)
|
Ingestion of infective ova
|
Yes
|
1 month
|
Extraintestinal migration is very rare[3]
|
Free in the lumen of cecum, appendix, adjacent colon
|
|
References
Template:WH
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