Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Mar 29;116(13):213-219.
doi: 10.3238/arztebl.2019.0213.

The Diagnosis and Treatment of Pinworm Infection

Sebastian Wendt  1 , Henning Trawinski, Stefan Schubert, Arne C Rodloff, Joachim Mössner, Christoph Lübbert
Affiliations

The Diagnosis and Treatment of Pinworm Infection

Sebastian Wendt et al. Dtsch Arztebl Int. .

Abstract

Background: Symptomatic infection with pinworm (Enterobius vermicularis), a human pathogen, is clinically relevant in Germany, with an estimated prevalence in childhood of 2-20%. Enterobiasis can cause major mental distress. There is little systematically verified knowledge on the treatment of this condition, and there is no corresponding German guideline. This review is, therefore, intended as a summary of the current state of knowledge.

Methods: This review is based on pertinent publications retrieved by a selective search in PubMed for literature appearing from 1 January 1990 to 5 February 2019 and containing the search terms "enterobiasis," "oxyuriasis," "Enterobius vermicula- ris," "pinworm," and "threadworm."

Results: More than one billion people worldwide are thought to be infected with pinworm. Estimates of its prevalence among kindergarten and primary-school pupils in Europe are generally near 20%. Infants (<2 years of age), adolescents (>14 years of age), and adults are only sporadically affected. The main risk factors are age 4-11 years, uncontrolled anus-finger-mouth contact, nail-biting (onychophagia/peri- onychophagia), unsupervised body hygiene, and poor compliance with basic hand hygiene. No large-scale, randomized, controlled trials of treatment are available. The approved antihelminthic agents are mebendazole, pyrantel embonate, and pyrvinium embonate (success rates up to >90%). For recurrent infections, prolonged treatment for up to 16 weeks (a "pulse scheme") is recommended.

Conclusion: In nearly all cases, antihelminthic treatment along with attention to hygienic measures can successfully eradicate pinworm infection and prevent recurrence and autoinfection. The involvement of all persons living in the patient's house- hold, including sexual partners, is a prerequisite to the lasting success of treatment.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Colonoscopic detection of Enterobius vermicularis in the cecum of an adult patient that holidayed on an organic farm
Figure 2
Figure 2
Microscopic detection of an Enterobius vermicularis egg in stool (400x magnification)
Figure
Figure
Life cycle of Enterobius vermicularis (modified from [13])
Figure 3
Figure 3
Microscopic detection of Enterobius vermicularis eggs in a Scotch tape specimen (100x magnification)
eFigure
eFigure
A microscopic specimen of an adult Enterobius vermicularis: the head section is rounded and contains a muscular esophagus and bulb (100x magnification).
See this image and copyright information in PMC

Comment in

  • Critical Remarks.
    Feldmeier H, Richter PJ, Ignatius R. Feldmeier H, et al. Dtsch Arztebl Int. 2019 Aug 9;116(33-34):561. doi: 10.3238/arztebl.2019.0561a. Dtsch Arztebl Int. 2019. PMID: 31554545 Free PMC article. No abstract available.
  • In Reply.
    Wendt S, Rodloff AC, Lübbert C. Wendt S, et al. Dtsch Arztebl Int. 2019 Aug 9;116(33-34):561-562. doi: 10.3238/arztebl.2019.0561b. Dtsch Arztebl Int. 2019. PMID: 31554546 Free PMC article. No abstract available.

References

    1. Gauert B. Eine vergleichende Untersuchung über Vorkommen und Verbreitung von Intestinalparasiten in Kindertagesstätten der Landeshauptstadt Schwerin. Gesundheitswesen. 1998;60:301–306. - PubMed
    1. Friesen J, Bergmann C, Neuber R, et al. Detection of Enterobius vermicularis in greater Berlin, 2007-2017: seasonality and increased frequency of detection. Eur J Clin Microbiol Infect Dis. 2019 doi: 10.1007/s10096-019-03495-1. - PubMed
    1. Kubiak K, Dzika E, Paukszto L. Enterobiasis epidemiology and molecular characterization of Enterobius vermicularis in healthy children in north-eastern Poland. Helminthologia. 2017;54:284–291.
    1. Ibarra J. Threadworms: a starting point for family hygiene. Br J Community Nurs. 2001;6:414–420. - PubMed
    1. Deplazes P, Eckert J, von Samson-Himmelstjerna G, Zahner H. Enke Verlag. 3. Stuttgart: 2013. Lehrbuch der Parasitologie für die Tiermedizin. - PubMed