Acute appendicitis and Enterobius vermicularis infestation

• Published in: Canadian Medical Association journal (CMAJ) Vol. 191; no. 17; p. E477
• Main Authors: Habashi, Rogeh, MD, Lisi, Michael Patrick, MD
• Format: Journal Article
• Language: English
• Published: Canada Joule Inc 29.04.2019; CMA Impact, Inc
• Subjects: Acute Disease; Animals; Appendectomy; Appendicitis; Appendicitis - parasitology; Appendicitis - therapy; Appendix - parasitology; Appendix - surgery; Care and treatment; Case reports; Case studies; Child; Childrens health; Diagnosis; Diagnostic imaging; Enterobiasis; Enterobiasis - diagnosis; Enterobiasis - therapy; Enterobius - isolation & purification; Humans; Infections; Internal Medicine; Laparoscopy; Leukocyte Count; Male; Medical diagnosis; Medical examination; Parasites; Practice; Pruritus; Pyrantel pamoate; Surgery; Ultrasound imaging; Canada
• ISSN: 0820-3946; 1488-2329
• DOI: 10.1503/cmaj.181194

A 9-year-old Canadian boy presented to the emergency department with a 4-day history of sudden, unremitting pain in the right iliac fossa. His medical history was otherwise unremarkable, and he had not travelled recently. The patient was afebrile, and physical examination showed focal tenderness at the McBurney point. His total leukocyte count was 10.8 (normal 4.5-11.0) x 109 cells/L with a normal differential, and ultrasonography did not visualize the appendix. We diagnosed acute appendicitis and performed an urgent laparoscopic appendectomy. Although pinworm infestation is the most common intestinal helminth infection worldwide, simultaneous E. vermicularis infection and appendicitis is rare in Canada, accounting for less than 0.6% of all appendicitis presentations. It is likely that no causal relation exists between appendicitis and pinworm infection, as appendiceal inflammation is not typically found.