Enterobius vermicularis in the Endometrium of the Uterus: A Case Report
AbstractEnterobius vermicularis is an intestinal nematode of humans and the most common helminth infection. Main transmission path is direct contact between infected and uninfected person meaning ingestion of the eggs. Human infections are usually asymptomatic or manifest as perianal itching. Although ectopic locations are uncommon, Enterobius can occasionally be detected in appendix, kidney, male urinary tract and female genital tract. We present a case from Varaždin General Hospital, Varaždin, Croatia in 2012, involving a 90-yr-old female patient who underwent hysterectomy leading to accidental finding of E. vermicularis in the uterus despite being asymptomatic for enterobiasis. Since there were no signs and symptoms of parasitic infection, no antiparasitic drugs were administered. Parasite was not observed during macroscopic examination, yet microscopic examination of the material demonstrated helminth within endometrium surrounded by dense inflammatory infiltrate, predominantly lymphocytes and some eosinophils. Internal structures of the parasite were collapsed, while well-developed musculature and cuticle were preserved. We present this case to educate and remind physicians on this parasitosis as possible diagnosis. Although non-gastrointestinal locations of Enterobius infestation are rare, this infection should be considered in patients with abdominal pain, genitourinary symptoms, and pelvic pain in order to apply appropriate treatment and prevent further complications.
Al-Saffar F, Najjar N, Ibrahim S, Clark M. Pin worms presenting as suspected Crohn's disease. Am J Case Rep. 2015;16:737-9.
Gazvani MR, Emery SJ. Intraperitoneal Enterobius vermicularis infection: a case report. Infect Dis Obstet Gynecol. 1996;4(1):28-30.
Zahariou A, Karamouti M, Papaioannou P. Enterobius vermicularis in the male urinary tract: a case report. J Med Case Rep. 2007;1:137-9.
Ng YW, Ng SB, Low JJ. Enterobius vermicularis infestation of the endometrium - a cause of menstrual irregularity and review of literature. Ann Acad Med Singapore. 2011;40(11):514-5.
Al-Rufaie HK, Rix GH, Pérez Clemente MP, Al-Shawaf T. Pinworms and postmenopausal bleeding. J Clin Pathol. 1998;51(5):401-2.
Raju K, Verappa S, Venkataramappa SM. Enterobius vermicularis infestation masquerading as cervical carcinoma: A cytological diagnosis. J Nat Sci Biol Med. 2015;6(2):476-9.
Ngui R, Ravindran S, Ong DB, Chow TK, Low KP, Nureena ZS, Rajoo Y, Chin YT, Amir A, Ahmad AF, Lim YA, Mahmud R. Enterobius vermicularis salpingitis seen in the setting of ectopic pregnancy in a Malaysian patient. J Clin Microbiol. 2014;52(9):3468-70.
Tandan T, Pollard AJ, Money DM, Scheifele DW. Pelvic inflammatory disease associated with Enterobius vermicularis. Arch Dis Child. 2002;86(6):439-40.
Efraimidou E, Gatopoulou A, Stamos C, Lirantzopoulos N, Kouklakis G. Enterobius Vermicularis infection of the appendix as a cause of acute appendicitis in a Greek adolescent: a case report. Cases J. 2008;1(1):376-8.
Rizvi G, Rawat V, Pandey HS, Kumar M. Acute abdomen: an uncommon presentation of a common intestinal nematode. Trop Parasitol. 2015;5(2):123–6.
Shetty JB, Kulkarni DV, Prabhu V. Eggs containing larvae of Enterobius vermicularis in vaginal smear. J Cytol. 2012;29(1):94-6.
|Issue||Vol 12 No 4 (2017)|
|Enterobius vermicularis Ectopic parasite Endometrium Uterus Croatia|
|Rights and permissions|
|This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.|