Case Files Paediatrics Chapter 38 Enterobius Vermicularis

Front 1

1. Nematode (roundworms)?

Back 1

a. Cylindrical organisms, w/thousands of different species, only a few of which are parasitic.
b. Nematode infection is one of the most common types of infection in humans

Front 2

1. Is feces exam used to identify Ova for E. vermicularis?

Back 2

a. No, bc the eggs are small and few. Go with the cellophane tape.

Front 3

3. Most common nematode infection in North American?

Back 3

a. Enterobius vermicularis.

Front 4

4. Only natural host of Enterobius vermicularis?

Back 4

a. Humans

Front 5

5. Risk factors for Enterobius vermicularis infection?

Back 5

a. Exposure to other children in a day care environment or in the home.

Front 6

6. How is Enterobius vermicularis transmitted?

Back 6

a. The eggs are transferred from clothes, fingers (from itching), and bed sheets.
b. An infection results from egg ingestion.
c. The larvae then hatch in the in the duodenum and grow to adult worms in 4-6 weeks.

Front 7

7. Symptoms of pinworm?

Back 7

a. Nocturnal perianal itching: most commonly.
i. This is a result of worm and ova hypersensitivity.
b. The gravid worms occasionally migrate to the perianal area, resulting in vaginal itching and discharge.

Front 8

8. Tx options for pinworm?

Back 8

1. Mebendazole
2. Albendazole
3. Pyrantel pamoate

b. These are often in a single dose.
c. Often a second dose is given 2 weeks after the first dose to eliminate any new worms released from ova ingested proximate to the treatment time.

Front 9

9. Source of infection for: Ascariasis (Ascaris lumbricoides)?

Back 9

a. Egg ingestion, usually from soil contaminated w/human feces.

Front 10

10. S/S of: Ascariasis (Ascaris lumbricoides)?

Back 10

a. Most asymptomatic
b. Haemoptysis
c. Pulmonary infiltrates
d. Abdominal pain
e. Distention
f. Occasional intestinal obstruction.

Front 11

11. Diagnosis of: Ascariasis (Ascaris lumbricoides)?

Back 11

a. Embryonate and non-embryonate eggs in stool
b. Occasionally see adult worms in stool or coughed up.

Front 12

12. Treatment of: Ascariasis (Ascaris lumbricoides)?

Back 12

a. Albendazole single dose, mebendazole for 3 days or a single dose of pyrantel pamoate.
b. Obstruction may be cleared w/piperazine salts (causes worm paralysis and expulsion).

Front 13

13. Source of infection for (Ancylostoma duodenale; Necator americanus)?

Back 13

a. Larvae in soil penetrate exposed skin.

Front 14

14. S/S of: Hookworms (Ancylostoma duodenale; Necator americanus)?

Back 14

a. Pruritus and rash at site of entry
b. Epigastric pain and diarrhea
c. Anaemia from blood loss
d. Respiratory symptoms

Front 15

15. Diagnosis of: Hookworms (Ancylostoma duodenale; Necator americanus)?

Back 15

a. Characteristic ovoid eggs in stool

Front 16

16. Treatment of: Hookworms (Ancylostoma duodenale; Necator americanus)?

Back 16

1. Mebendazole for 3 days
2. Or
3. Albendazole single dose
4. Or
5. Pyrantel pamoate
b. Include Iron supplement for anaemia

Front 17

17. Source of infection for: Pinworms (Enterobius vermicularis)?

Back 17

a. Egg ingestion

Front 18

18. S/S of: Pinworms (Enterobius vermicularis)?

Back 18

a. Many asymptomatic
b. Nocturnal perianal itching most common.

Front 19

19. Diagnosis of: Pinworms (Enterobius vermicularis)?

Back 19

a. Microscopy of cellophane tape applies to anus reveals eggs.
b. Routine stool ova and parasites not useful.

Front 20

20. Treatment of: Pinworms (Enterobius vermicularis)?

Back 20

a. Pyrantel pamoate
b. Or Mebendazole or albendazole
c. Single dose with a second dose 2-3 weeks later.

Front 21

21. Source of infection for: Strongyloides stercoralis?

Back 21

a. Larvae penetrate skin and move to lungs and then intestines
b. Also auto-infectious
c. Larvae can move from intestines into blood stream, to lungs, and back to intestines.

Front 22

22. S/S of: Strongyloides stercoralis?

Back 22

a. Can be asymptomatic
b. Can cause epigastric pain, emesis, diarrhea, malabsorption, weight loss.

Front 23

23. Diagnosis of: Strongyloides stercoralis?

Back 23

a. Larvae in feces
b. Or
c. Sample of duodenal fluid by a string test

Front 24

24. Treatment of: Strongyloides stercoralis?

Back 24

a. Ivermectin for 1-2 days
b. Or
c. Thiabendazole for 2 days
d. May requires up to 2 wks of therapy, based on subsequent stool examinations

Front 25

25. Source of infection for: Visceral and Ocular larva migrans (Toxocara canis; Toxocara cati; Toxocara leonina; Baylisascaris procyonis)?

Back 25

a. Egg ingestion, usually from soil contaminated w/dog or cat feces.

Front 26

26. S/S of: Visceral and Ocular larva migrans (Toxocara canis; Toxocara cati; Toxocara leonina; Baylisascaris procyonis)?

Back 26

a. Fever
b. Cough
c. Occasional abdominal pain
d. Hepatomegaly
e. Rhonchi
f. Skin lesions

Front 27

27. Diagnosis of: Visceral and Ocular larva migrans (Toxocara canis; Toxocara cati; Toxocara leonina; Baylisascaris procyonis)?

Back 27

a. Clinical presentation and serologic testing
b. Microscopy of affected tissue occasionally reveals larvae.

Front 28

28. Treatment of: Visceral and Ocular larva migrans (Toxocara canis; Toxocara cati; Toxocara leonina; Baylisascaris procyonis)?

Back 28

a. Visceral: None, self-limited disease.
b. Ocular:
1. Diethylcarbamazine
2. And
3. Albendazole for 3-5 days
4. Or
5. Mebendazole for 5 days.
c. Use with caution as death of organisms may precipitate inflammatory reaction.

Front 29

29. Source of infection for: Whipworms (Trichuris Trichiura)?

Back 29

a. Egg ingestion

Front 30

30. S/S of: Whipworms (Trichuris Trichiura)?

Back 30

a. Most asymptomatic
b. Can cause:
1. Proctitis
2. Bloody diarrhea
3. Abdominal pain
4. Rectal prolapse