Epidemiology
E. vermicularis infections are widespread, often asymptomatic, and frequently spread through significant environmental contamination, particularly affecting children in institutions and households [PMID:41752155].
Fossil evidence and evolutionary studies suggest that E. vermicularis has coexisted with humans for thousands of years, highlighting its enduring presence in human populations [PMID:41752155].
Clinical Presentation
Ectopic infections of Enterobius vermicularis, though rare, have been reported in various extraintestinal sites and often present with nonspecific symptoms including abdominal pain and masses, potentially leading to misdiagnosis [PMID:41776700].
Most cases of E. vermicularis infection remain asymptomatic, leading to hidden spread and potential reinfection among contacts [PMID:41752155].
Two cases of vaginal enterobiasis were identified incidentally through cervical cytology without reported gynaecological or gastrointestinal symptoms [PMID:28905520].
Diagnosis
Eosinophilia is highlighted as a significant indicator of pinworm infection, particularly relevant in diagnosing ectopic manifestations of Enterobius vermicularis [PMID:41776700].
EV eggs were identified in cervico-vaginal smears, highlighting the importance of cytological identification in diagnosing extra-intestinal manifestations [PMID:28905520].
Differential Diagnosis
Given the potential for Enterobius vermicularis to migrate ectopically, causing inflammatory granulomas or pseudotumorous lesions, it is crucial to include this diagnosis in cases of abdominal masses and lesions, particularly in regions with known prevalence [PMID:41776700].
Complications
There is a noted risk of ascending infections leading to severe complications, emphasizing the clinical significance of diagnosing EV in cervico-vaginal samples [PMID:28905520].
References
1 Cai Y, Miao F, Chen M, Sun J, Hu Y, Qin X et al.. Rare Enterobius vermicularis infection of the greater omentum misdiagnosed as schistosomiasis: a case report. Infectious diseases of poverty 2026. link 2 Kaneva E, Dimitrova R, Tsvetkova N, Harizanov R, Velcheva D, Ivanova A et al.. Genotypic Analysis of Enterobius vermicularis (Rhabditida: Oxyuridae, Linnaeus, 1758) Among Infected Individuals in Bulgaria: A First Phylogenetic Study. International journal of molecular sciences 2026. link 3 Tsai CY, Junod R, Jacot-Guillarmod M, Beniere C, Ziadi S, Bongiovanni M. Vaginal Enterobius vermicularis diagnosed on liquid-based cytology during Papanicolaou test cervical cancer screening: A report of two cases and a review of the literature. Diagnostic cytopathology 2018. link