Pinworms

Pinworm eggs

Pinworms are a common problem in children and may spread to adults (typically the parents or other care-givers). The eggs may be easily seen under a microscope. To obtain a sample, a piece of cellophane tape is pressed against the patient’s anal opening. The sticky side of the tape picks up the pinworm eggs and the tape is then stuck to a microscope slide. The eggs can be viewed under the microscope, as seen above. (Image courtesy of the Centers for Disease Control and Prevention.)

Also known as: Enterobiasis, Oxyuriasis, Threadworm, Seatworm, Enterobius vermicularis, E vermicularis or Helminthic infection

Definition

Pinworms are small worms that infect the intestines.

Causes, incidence, and risk factors

Pinworms are the most common worm infection in the United States. They are most common in school-age children.

Pinworm eggs are spread directly from person to person. They can also be spread by touching bedding, food, or other items contaminated with the eggs.

Typically, children are infected by unknowingly touching pinworm eggs and putting their fingers in their mouths. The eggs are swallowed, and eventually hatch in the small intestine. The worms mature in the colon.

Female worms then move to the child's anal area, especially at night, and deposit more eggs. This may cause intense itching. The area may even become infected. When the child scratches the itching anal area, the eggs can get under the child's fingernails. These eggs can be transferred to other children, family members, and items in the house.

Symptoms

  • Difficulty sleeping due to the itching that occurs during the night
  • Intense itching around the anus
  • Irritability due to itching and interrupted sleep
  • Irritated or infected skin around the anus, from constant scratching
  • Irritation or discomfort of the vagina in young girls (if an adult worm enters the vagina rather than the anus)
  • Loss of appetite and weight (uncommon, but can occur in severe infections)

Signs and tests

Pinworms can be spotted in the anal area, especially at night when the worms lay their eggs there.

Your doctor may have you do a tape test. A piece of cellophane tape is pressed against the skin around the anus, and removed. This should be done in the morning before bathing or using the toilet, because bathing and wiping may remove eggs. The doctor will stick the tape to a slide and look for eggs using a microscope.

Treatment

The main treatment is a single dose of either mebendazole or albendazole, which kill the pinworms (not the eggs).These are available over-the-counter and by prescription.

More than one household member is likely to be infected, so the entire household is often treated. The single-dose treatment is often repeated after 2 weeks. This treats worms that hatched since the first treatment.

To control the eggs:

  • Clean toilet seats daily
  • Keep fingernails short and clean
  • Wash all bed linens twice a week
  • Wash hands before meals and after using the toilet

Avoid scratching the infected area around the anus. This can contaminate your fingers and everything else that you touch afterwards.

Keep your hands and fingers away from your nose and mouth unless they are freshly washed. Carry out these measures while family members are being treated for pinworms.

Expectations (prognosis)

Pinworm infection is fully treatable.

Complications

Calling your health care provider

Call for an appointment with your health care provider if:

  • You or your child has symptoms of pinworm infection
  • You have seen pinworms on your child

Prevention

Wash hands after using the bathroom and before preparing food. Wash bedding and underclothing frequently, especially those of any affected family members.

References

Dent AE, Kazura JW. Enterobiasis (Enterobius Vermicularis). In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 291.

See also:

Review date:
July 26, 2010
Reviewed by:
Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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