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==Differentiating Enterobiasis from other diseases==
==Differentiating Enterobiasis from other diseases==
The table below summarizes other major causes of pruritus ani(anal pruritus).
The table below summarizes other major causes of pruritus ani(anal pruritus).<ref name="pmid18765023">{{cite journal |vauthors=Siddiqi S, Vijay V, Ward M, Mahendran R, Warren S |title=Pruritus ani |journal=Ann R Coll Surg Engl |volume=90 |issue=6 |pages=457–63 |year=2008 |pmid=18765023 |pmc=2647235 |doi=10.1308/003588408X317940 |url=}}</ref><ref name={{cite book | last = Fleshman | first = James | title = The ASCRS textbook of colon and rectal surgery | publisher = Springer | location = New York, NY | year = 2007 | isbn = 978-0-387-36374-5 }}</ref><ref name="urlPruritis Ani Expanded Version | ASCRS">{{cite web |url=+https://www.fascrs.org/patients/disease-condition/pruritis-ani-expanded-version |title=Pruritis Ani Expanded Version &#124; ASCRS |format= |work= |accessdate=}}</ref>
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Revision as of 23:16, 23 June 2017


Enterobiasis Microchapters

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Overview

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Differentiating Enterobiasis from other Diseases

Epidemiology and Demographics

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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 diseases causing pruritis ani and the nematode infections.

Differentiating Enterobiasis from other diseases

The table below summarizes other major causes of pruritus ani(anal pruritus).[1]

Causes Suggestive findings Diagnostic approach Treatment
Skin

infections

Bacterial
  • Skin edema, erythema, and warmth.
  • Pruritus, 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 scrapings.
  • Topical antifungals.
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.
  • Physical examination.
  • Topical emollients.
  • Topical steroids.
Seborrheic dermatitis
  • Erythematous, yellow, oily plaques.
  • Mild pruritus.
  • Physical examination.
  • Topical emollients.
  • Topical steroids.
  • Topical ketoconazole.
Contact dermatitis
  • Erythematous, pruritic skin lesion.
  • Physical examination.
  • Avoid irritants.
  • Topical steroids.
Lichen planus
  • Pruritic, purple, polygonal plaques or papules.
  • Physical examination.
  • Punch/shave biopsy
  • Topical steroids.
  • Phototherapy.
Lichen sclerosis
  • Vulvular/anal pruritis and thinning of the skin.
  • Physical examination.
  • Punch/shave biopsy
  • Topical steroids.
Perianal carcinoma (Bowen disease or Paget's disease)
  • Rectal bleeding.
  • Perianal pruritus.
  • Eczematous plaque.
  • Rectal mass.
  • Physical examination.
  • Sigmoidoscopy/colonoscopy.
  • CT/PET scan.
  • Surgery.
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.
Hygiene

Related problems

Excessive sweating and Poor cleaning
  • Wearing tight undergarments or synthetic clothes.
  • Exclusion of medical causes.
  • Use of cotton undergarments.
  • Frequently changing undergarments.
Meticulous cleansing of anal area
  • Inappropriate cleansing practices.
  • Exclusion of medical causes.
  • Patient education and change of practice.
Skin irritants
  • Use of ointments, soaps, sanitary wipes.
  • Exclusion of medical causes.
  • Avoidance of the irritant use.

The table below summarizes the findings that differentiate enterobiasis from other nematode infections.

Differentiating Enterobiasis from other Nematode infections[2][3]
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[4] Free in the lumen of cecum, appendix, adjacent colon

References

  1. ↑ Siddiqi S, Vijay V, Ward M, Mahendran R, Warren S (2008). "Pruritus ani". Ann R Coll Surg Engl. 90 (6): 457–63. doi:10.1308/003588408X317940. PMC 2647235. PMID 18765023.
  2. ↑ Durand, Marlene (2015). "Chapter 288:Intestinal Nematodes (Roundworms)". Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases Updated Edition, Eighth Edition. Elsevier. pp. 3199–3207. ISBN 978-1-4557-4801-3.
  3. ↑ Kim, Kami; Weiss, Louis; Tanowitz, Herbert (2016). "Chapter 39:Parasitic Infections". Murray and Nadel's Textbook of Respiratory Medicine Sixth Edition. Elsevier. pp. 682–698. ISBN 978-1-4557-3383-5.
  4. ↑ Serpytis M, Seinin D (2012). "Fatal case of ectopic enterobiasis: Enterobius vermicularis in the kidneys". Scand J Urol Nephrol. 46 (1): 70–2. doi:10.3109/00365599.2011.609834. PMID 21879805.

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