The Rare Association of Enterobius vermicularis Infestation Causing Acute Appendicitis in Children: A Case Report and Review of the Literature
Journal Title: Scholars Journal of Applied Medical Sciences - Year 2015, Vol 3, Issue 1
Abstract
Acute appendicitis is the commonest causes of emergency surgery, having worldwide prevalence and affects all age groups. The etiology of acute appendicitis is multi-factorial and the pathology is most likely the obstruction of the lumen of the appendix. Acute appendicitis due to helminthes and protozoan infection is quite rare. Other unusual findings in appendectomy specimens are benign or malignant tumors. The presence of parasitic helminth Enterobius vermicularis (pinworm) in the appendix sometimes produces symptoms of acute appendicitis without any histological evidence, even though a patient might not have appendicitis. The causal relationship of appendicitis and pin worms’ remains controversial. We present here a case of an 11-year old boy with enterobiasis of appendix presented with clinical features of acute appendicitis. E. vermicularis was discovered inadvertently after laproscopic appendectomy in a highly inflamed appendix. Prior to surgery, no parasites were revealed histopathologically. The relevant literature is also reviewed as accessed via PubMed and Google Scholar databases. Pinworm infestation can have various clinical presentations, including non-specific symptoms of decreased appetite, peri-anal pruritis, and loss of sleep. In acute condition, it can produce symptoms of 'appendiceal colic', or acute appendicitis in a non-inflamed appendix; or induce chronic inflammatory eosinophilic infiltrate or no tissue reaction in a histological appendicitis. In conclusion, the most common surgical condition in children is acute appendicitis. Parasitic infestations are a concern on a worldwide basis. The role of parasitic infestation in relation to appendicitis is controversial. Intestinal parasites may cause noteworthy morbidity and mortality.
Authors and Affiliations
Sheikh Hasan Habib, Waliza Ansar, Shyamasree Ghosh, Achintya Kumar Das
Keywords
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