Symptoms and complications of entanglement are so serious

Ringworm disease is a common disease in children. The main symptom is perianal itching, especially at night. Severe infection can lead to gastrointestinal dysfunction, vomiting, diarrhea, fever, abdominal pain, etc.; if not treated in time, complications such as appendicitis, pelvic inflammatory disease, peritonitis, intestinal obstruction, etc. may occur.

1. Clinical manifestations

Due to different degrees of infection and ectopic parasitism, there may be no obvious clinical symptoms or different symptoms and signs may appear.

1. The most common symptom is perianal itching, especially at night. Severe infection can lead to gastrointestinal dysfunction, vomiting, diarrhea, fever, abdominal pain, etc.

2. Ectopic parasitism manifestations:

⑴ Pinworm appendicitis: Pinworms parasitize in the appendix cavity and can also invade the appendix tissue, causing acute or chronic appendicitis. Patients may experience paroxysmal abdominal pain, mainly in the right lower abdomen. May be accompanied by nausea, vomiting, and fever. Blood tests may show elevated neutrophils and eosinophils.

⑵ Inflammation of the urinary and reproductive system: Pinworms can invade the female vulva and enter the various organs of the reproductive system through the vagina, causing vulvitis, vaginitis, endometritis and even peritonitis.

⑶Manifestations in other parts of the body: perianal abscess, anal fistula and inflammatory granuloma. Invasion of the pelvic and abdominal cavities can cause abdominal pain, symptoms of peritonitis, etc.

2. Complications

Different complications may occur depending on the parasitic site, such as appendicitis, pelvic inflammatory disease, peritonitis, intestinal obstruction, etc.

3. Diagnosis and Differentiation

1. Diagnostic criteria

This disease should be considered when anal itching or vaginitis of unknown cause occurs.

Because the symptoms caused by ectopic pinworms are relatively complex, internal medicine, surgery, and gynecology physicians must have sufficient knowledge and vigilance to make correct diagnosis and treatment in a timely manner.

2. Etiological diagnosis

The diagnosis of pinworm infection or enterobiasis is based on the detection of adult pinworms or pinworm eggs.

⑴ Transparent tape egg sticking method: Stick a 2cm wide and 6cm long transparent tape on the slide for later use. During the examination, lift up one end of the tape and use the adhesive surface to stick it to the skin around the anus of the subject. Then stick the tape flat on a glass slide and examine it under a microscope. This test should be performed in the early morning before the subject has a bowel movement.

⑵ Check for adult worms around the anus: If small white worms are found around the anus, use tweezers to place them in a small bottle containing 70% ethanol and send them for examination.

3. Differential diagnosis

The diagnosis of enterobiasis is not difficult, but it should be differentiated from other diseases when there is ectopic parasitism or complications.

The local symptoms of enterobiasis should be differentiated from other infections; the gastrointestinal symptoms should be differentiated from other gastrointestinal diseases and intestinal parasitic diseases; and the ectopic parasitic lesions should be differentiated from the corresponding diseases caused by other reasons. No worm eggs were found in the perianal area in any of the above diseases.