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Enterobius Vermicularis

Enterobius vermicularis, commonly known as the pinworm, is the most common parasitic worm infection worldwide. It is a small, white thread-like worm that infects the intestine. The female worm migrates to the rectum and anus at night to lay thousands of sticky eggs, which can cause intense itching. The eggs can be ingested through contaminated fingers or autoinfection, hatch in the intestine, and develop into adult worms over 2-12 weeks, completing the life cycle.

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105 views16 pages

Enterobius Vermicularis

Enterobius vermicularis, commonly known as the pinworm, is the most common parasitic worm infection worldwide. It is a small, white thread-like worm that infects the intestine. The female worm migrates to the rectum and anus at night to lay thousands of sticky eggs, which can cause intense itching. The eggs can be ingested through contaminated fingers or autoinfection, hatch in the intestine, and develop into adult worms over 2-12 weeks, completing the life cycle.

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YA MAAP
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We take content rights seriously. If you suspect this is your content, claim it here.
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Enterobius vermicularis

world’s most common parasite


The name Enterobius vermicularis means a tiny worm living in the intestine
(Greek enteron—intestine, bios—life, and vermiculus—small worm).
It is worldwide in distribution. Unlike the usual situation,where
helminthic infections are more prevalent in the poor people of the
tropics, E. vermicularis is one worm infestation which is far more
common in the affluent nations in the cold and temperate regions
(cosmopolitan).
MORPHOLOGY
EGG
• It floats in saturated salt solution.
• It has a characteristic shape, being elongated ovoid,
• Flattened on one side, and convex on the other(planoconvex),
• Measuring 50–60 μm by 20–30 μm
• The egg shell is double layered and relatively thick, though transparent. The outer
albuminous layer makes the eggs stick to each other and to clothing and
otherobjects.
• The egg contains a tadpole-shaped coiled embryo, which is fully formed, but
becomes infectious only 6 hours after being deposited on the skin.
• Under cool moist conditions, the egg remains viable for about 2 weeks (Fig. 19.2).
• A single female worm lays 5,000–17,000 eggs.
Adult Worm
• short, white, fusiform worms
• Have pointed ends
• Looking like bits of white thread.
• The mouth is surrounded by 3 wing-like cuticular expansions (cervical
alae).
• The esophagus has a double-bulb structure
Male Worm
• The male worm is 2–5 mm
long and 0.1–0.2 mm thick.
• Its posterior end is tightly
curved ventrally
• Carries a prominent
copulatory spicule on
• Males live for about 7–8
weeks.
Female
• Its posterior third is drawn into a
thin pointed pin-liketail .
• The vulva is located just in front of
the middle third of the body and
opens into the single vagina
• The whole body is filled by the
distended uteri carrying thousands
of eggs.
• The worm is oviparous.
• Females survive for 5–12 weeks.
LIFE CYCLE

Leuckart (1865) first described


the complete life cycle of
pinworm.
Natural host: Man
Infective form: Embryonated eggs
Mode of infection:
• Man acquires infection by ingesting embryonated eggs containing larva by means of
Contaminated fingers
 Autoinfection
• Eggs laid on perianal skin containing infective larvae are swallowed and hatch out in
the intestine.
• They moult in the ileum and enter the caecum, where they mature into adults.
• It takes from 2 weeks to 2 months from the time the eggsare ingested, to the
development of the gravid female, ready to lay eggs.
• The gravid female migrates down the colon to the rectum. At night, when
the host is in bed, the worm comes out through the anus and crawls
about on theperianal and perineal skin to lay its sticky eggs. The worm
may retreat into the anal canal and come out again to lay more eggs.
• The male is seldom seen as it does not migrate. It usually dies after
mating and is passed in the feces.
• When all the eggs are laid, the female worm dies or gets crushed by the
host during scratching. The worm may often be seen on the feces, having
been passively carried from the rectum. The eggs, however, are only
infrequently found in feces, as the female worm lays eggs in the perianal
area and not the rectum.
• Crawling of the gravid female worm leads to pruritis andthe patient
scratches the affected perianal area. These patients have eggs of E.
vermicularis on fingers and under nails leading to autoinfection
Infection
• Autoinfection: Ingestion of eggs due to scratching of perianal area
with fingers leading to deposition of eggs under the nails.

• Retroinfection: In this process, the eggs laid on the perianal skin


immediately hatch into the infective stagelarva and migrate through
the anus to develop into worms in the colon.
Pathogenesis
• intense irritation and pruritus of the perianal and perineal area (pruritis ani), when
it crawls out of the anus to lay eggs. This leads to scratching and excoriation of the
skin around the anus.
• Sleep DIsturbance. As the worm migrates out at night, it disturbs sleep. Nocturnal
enuresis is sometimes seen.
• The worm crawling into the vulva and vagina causes irritation and a mucoid
discharge.
• It may migrate upto the uterus, fallopian tubes and into the peritoneum. This may
cause symptoms of chronic salpingitis, cervicitis, peritiontis, and recurrent urinary
tract infections.
• The worm is sometimes found in surgically removed appendix and has been claimed
to be responsible for appendicitis.
Source
• Jawetz, Melnick, & Adelberg’s Medical Microbiology Twenty-Seventh
Edition
• Paniker’s Textbook of Medical Parasitology Seventh Edition

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