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An adult pinworm generally is 1/4 to 1/2 inch (about 6 to 13 millimeters) in length. The most common symptom of infection is anal itching, particularly at night, as worms migrate to the host's anal area to lay their eggs.
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While the infected person sleeps, female pinworms lay thousands of eggs in the folds of skin surrounding the anus. Most people infected with pinworms have no symptoms, but some people experience anal itching and restless sleep.
Accidentally swallowing or breathing in pinworm eggs causes a pinworm infection. The tiny (microscopic) eggs can be carried to your mouth by contaminated food, drink or your fingers. Once swallowed, the eggs hatch in the intestines and mature into adult worms within a few weeks.
Female pinworms move to the anal area to lay their eggs, which often results in anal itching. When you scratch the itchy area, the eggs cling to your fingers and get under your fingernails. The eggs then get transferred to other surfaces, such as toys, bedding or toilet seats. The eggs can also be transferred from contaminated fingers to food, liquids, clothes or other people.
The parasite can travel from the anal area up the vagina to the uterus, fallopian tubes and around the pelvic organs. This can cause problems such as inflammation of the vagina (vaginitis) and inflammation of the inner lining of the uterus (endometritis).
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Your physician may choose to collect a swab of the pus for laboratory analysis and swabs from other areas of the body (nose, armpits, and/or anus and genital area) to determine if you are a carrier of staph. If you are a carrier, your doctor may prescribe a topical medication applied to the inside of the nose and/or oral antibiotics for several days. These measures can help prevent a recurrence of the boil(s) and decrease the possibility that you may unknowingly spread the germ to others. If your doctor prescribes antibiotics, be sure to take the full course of treatment to avoid the development of bacterial resistance to the antibiotic.
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Gravid adult female Enterobius vermicularis deposit eggs on perianal folds . Infection occurs via self-inoculation (transferring eggs to the mouth with hands that have scratched the perianal area) or through exposure to eggs in the environment (e.g. contaminated surfaces, clothes, bed linens, etc.) . Following ingestion of infective eggs, the larvae hatch in the small intestine and the adults establish themselves in the colon, usually in the cecum . The time interval from ingestion of infective eggs to oviposition by the adult females is about one month. At full maturity adult females measure 8 to 13 mm, and adult males 2 to 5 mm; the adult life span is about two months. Gravid females migrate nocturnally outside the anus and oviposit while crawling on the skin of the perianal area . The larvae contained inside the eggs develop (the eggs become infective) in 4 to 6 hours under optimal conditions .
Rarely, eggs may become airborne and be inhaled and swallowed. Retroinfection, or the migration of newly hatched larvae from the anal skin back into the rectum, may occur but the frequency with which this happens is unknown.
Enterobiasis is frequently asymptomatic. The most typical symptom is perianal pruritus, especially at night, which may lead to excoriations and bacterial superinfection. Occasionally, invasion of the female genital tract with vulvovaginitis and pelvic or peritoneal granulomas can occur. Other symptoms include, teeth grinding, enuresia, insomnia, anorexia, irritability, and abdominal pain, which can mimic appendicitis. E. vermicularis larvae are often found within the appendix on appendectomy, but the role of this nematode in appendicitis remains controversial. Very rare instances of eosinophilic colitis associated with E. vermicularis larvae have been reported.
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