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Suggest Medical Tests To Rule Out Intestinal Worm
Question: What is the best test to determine what kind of intestinal worm you have? I have tried egg and parasite test and tape test for pin worms but everything is coming back negative. I had an itching sensation around my anus ever since I was a very young boy and now I am 30. I didn't think my of it because it's gets itchy, I scratch and it goes away and it was only a few times a day. I thought to check one day and I could see white heads sticking out of the anus wall. I stared to monitor the situation without scratching and found sometimes up to 50 heads protruding from my anus wall, some of them I would probably consider a large size. I cannot identify what type of worm this is. How do I get rid of this? Thank you, I can't express how much I would appreciate this to be resolved. I have many pictures of the condition.
Brief Answer:
Enetrobiasis (Pinworm infestation)
Detailed Answer:
Hi,
Thank you for your query. I can understand your concerns.
The photograph show that your having Enetrobiasis (Pinworm infestation) with migration of the female worms. Perianal pruritus is due to release of eggs and the cardinal symptom.
Since pinworm eggs are not released in feces, the diagnosis cannot be made by conventional fecal ova and parasite tests( Egg and parasite test. Result: Negative as you quoted ).
Instead,eggs are detected by the application of clear cellulose acetate tape to the perianal region in the morning. After the tape with trapped eggs is transferred to a slide,microscopic examination will detect pinworm eggs, which are oval,measure 55 by 25 μm, and are flattened along one side.
The eggs become infective within hours and are transmitted by hand-to-mouth passage .Self infection is occurring in your case from perianal scratching and transport of infective eggs on the hands or under the nails to the mouth.
Always wash your hands thoroughly with soap and water after you scratch perianal region or after defecation. Regularly pair your nails.Nail-biting and scratching the bare anal area (scratch over cloth,if unresisting) are discouraged.Daily morning bath is encouraged as gravid female worms migrate nocturnally into the perianal region.
Adults should be treated with mebendazole (100 mg once) or albendazole (400 mg once), with the same treatment is repeated after 2 weeks.You have already undergone one course.
You need to repeat the course of Vermox (mebendazole) as the worms are still visible.
Also treatment of household members (say spouse) or close group contacts is advocated to eliminate asymptomatic reservoirs (Most pinworm infections are asymptomatic) of potential reinfection.
'Persisting' or relapsing infections are always due to re-infection,as adult worms can live for 6 weeks.
Thorough cleaning of toilets and floors,laundering of clothing and bedding,continuing for several days after treatment,will remove eggs from the environment.
Regards
Dr. T.K. Biswas M.D. XXXXXXX
Enetrobiasis (Pinworm infestation)
Detailed Answer:
Hi,
Thank you for your query. I can understand your concerns.
The photograph show that your having Enetrobiasis (Pinworm infestation) with migration of the female worms. Perianal pruritus is due to release of eggs and the cardinal symptom.
Since pinworm eggs are not released in feces, the diagnosis cannot be made by conventional fecal ova and parasite tests( Egg and parasite test. Result: Negative as you quoted ).
Instead,eggs are detected by the application of clear cellulose acetate tape to the perianal region in the morning. After the tape with trapped eggs is transferred to a slide,microscopic examination will detect pinworm eggs, which are oval,measure 55 by 25 μm, and are flattened along one side.
The eggs become infective within hours and are transmitted by hand-to-mouth passage .Self infection is occurring in your case from perianal scratching and transport of infective eggs on the hands or under the nails to the mouth.
Always wash your hands thoroughly with soap and water after you scratch perianal region or after defecation. Regularly pair your nails.Nail-biting and scratching the bare anal area (scratch over cloth,if unresisting) are discouraged.Daily morning bath is encouraged as gravid female worms migrate nocturnally into the perianal region.
Adults should be treated with mebendazole (100 mg once) or albendazole (400 mg once), with the same treatment is repeated after 2 weeks.You have already undergone one course.
You need to repeat the course of Vermox (mebendazole) as the worms are still visible.
Also treatment of household members (say spouse) or close group contacts is advocated to eliminate asymptomatic reservoirs (Most pinworm infections are asymptomatic) of potential reinfection.
'Persisting' or relapsing infections are always due to re-infection,as adult worms can live for 6 weeks.
Thorough cleaning of toilets and floors,laundering of clothing and bedding,continuing for several days after treatment,will remove eggs from the environment.
Regards
Dr. T.K. Biswas M.D. XXXXXXX
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Above answer was peer-reviewed by :
Dr. Prasad
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