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Pinworms

Pediatric Basics

By

Updated May 20, 2014

Mother Potty Training Her Son
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Although distressing for parents, pinworms cause mild infections or infestations.

Symptoms

Usual symptoms include rectal itching. More rarely, pinworms can cause vaginal itching and should be suspected in young girls with persistent vulvovaginitis.

Itching is usually worse at night and may interrupt your child's sleep.

Diagnosis

Diagnosis is often made by parents discovering live worms (small (1/2 inch size) white thread like worms in a child's stool) in children with typical symptoms. Testing is also available to look for eggs on a pinworm prep or collected with a scotch tape test (which your pediatrician will look at under a microscope).

Treatments

In children over age two years, treatment usually includes either mebendazole (Vermox) or Pin-X (pyrantel pamoate), an over-the-counter alternative to Vermox that is available as a liquid.

One of the keys to treatment of pinworms is to repeat the dose in 2 weeks to be sure and kill newly hatched eggs. Also, since some family members may have a pinworm infestation without symptoms, it is sometimes recommended that the whole family be treated, taking caution in treating children under age 2 years and pregnant women (ask your doctor first).

What You Need To Know

  • Pinworm infestations are caused by the Enterobius vermicularis roundworm. After ingesting roundworm eggs, they will migrate to a persons intestines and hatch. Four to six weeks later, adult female worms will discharge their eggs on the perianal skin. These eggs are contagious for up to 2-3 weeks, and are picked up as children scratch their bottom. The eggs can then be spread to others through direct contact or sharing other objects, like toys, clothing and bedding.
  • Adult pinworms die shortly after laying their eggs, but children typically reinfect themselves and keep the infection going.
  • Pinworm infestations do not cause any serious complications and it is considered a mild infection.
  • Other treatments and preventative measures might include cutting your child's nails short, encouraging frequent handwashing, encouraging kids to keep their fingers out of their mouth, and washing sheets, towels, etc. in hot water.
  • Perianal cellulitis (caused by the strep bacteria) can also cause rectal itching and is often misdiagnosed as a pinworm infestation. If your child also has redness around his rectum and/or doesn't respond to pinworm treatments or has multiple negative pinworm preps, you might ask your doctor about perianal cellulitis, which requires treatment with antibiotics and can be diagnosed with a regular rapid strep test or culture (like for strep throat).


Sources:

Long: Principles and Practice of Pediatric Infectious Diseases, 3rd ed.

Pinworm (enterobius vermicularis). Vermund SH - Semin Pediatr Infect Dis - 2000 Oct; 11(4); 252-256.

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