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Case Reports
. 2023 Mar 22;11(6):917.
doi: 10.3390/healthcare11060917.

Fatal Case of a Child Harboring Enterobius vermicularis

Samia T Al-Shouli  1 , Mazin Barry  2 , Khalifa Binkhamis  3 , Nourah AlHogail  4 , Nouf Omar Alafaleq  5 , Osman Adamu Dufailu  6 , Khaldoon Aljerian  7
Affiliations
Case Reports

Fatal Case of a Child Harboring Enterobius vermicularis

Samia T Al-Shouli et al. Healthcare (Basel). .

Abstract

Enterobius vermicularis is a threadlike parasite also known as "pinworms". It is the most common helminth infection, affecting the gastrointestinal tracts of children worldwide, although it seldom causes any fatalities. Enterobius vermicularis infections are usually asymptomatic and may only cause anal pruritis, with occasional reported cases of ectopic migration into the appendix or the female genital tract by adult pinworms. Here, we report a case of a 15-year-old girl who presented to the emergency department with high-grade fever, vomiting, and vague abdominal pain for three days. She was diagnosed with acute abdominal pain and underwent emergency ileocecectomy, but died the following day. Pathological examination of ileocecal junction showed intraluminal and intramural Enterobius vermicularis, which were attributed as the cause of her death in the absence of any other pathologies. Death due to Enterobius vermicularis is rare; this case calls for clinicians to be vigilant in exploring Enterobius vermicularis infections in patients with undiagnosed acute abdominal pain, since it could be a potential cause of death.

Keywords: Enterobius vermicularis; enterobiasis; pinworms; undiagnosed abdominal pain.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
(A) Full thick inflammation and necrosis (hematoxylin and eosin stain (H&E), magnification 200×). (B) Inflammation. (C) Necrosis and thrombosis (hematoxylin and eosin stain (H&E, magnification 200×).
Figure 2
Figure 2
(A) Periodic acid–Schiff (PAS), magnification 40×. (B) Hematoxylin and eosin stain (H&E), magnification 400×, of Enterobius vermicularis worms with eggs. (C) Periodic acid–Schiff (PAS), magnification 200×, showing worm embedded in the muscle wall with surrounding necrosis (arrows).
Figure 3
Figure 3
(A) Periodic acid–Schiff (PAS), magnification 40×. (B) Periodic acid–Schiff (PAS), magnification 200×, of female Enterobius vermicularis worms with eggs. (C) Periodic acid–Schiff (PAS), magnification 200×, showing worm in the lumen.
Figure 4
Figure 4
(A) Periodic acid–Schiff (PAS), magnification 200×. (B) Periodic acid–Schiff (PAS), magnification 200×, showing the presence of elongated worms with slender pointed tails, which is consistent with the morphological characteristics of Enterobius vermicularis worms.
See this image and copyright information in PMC

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