Pinworms: Etiology and Pathology (Pediatric Nursing)

00:00 Now let's talk about pinworms. This is an itchy and sticky situation.

00:05 This is the most common type of intestinal worm infection in the United States and it's very common worldwide.

00:11 These are thin and white worms measuring about a quarter to a half inch in length.

00:16 The female is going to lay thousands of eggs around the anus.

00:20 Infected patients can be asymptomatic. Some patients have anal itching and restless sleep.

00:26 And this is very common in school-age children.

00:29 We use medications to kill pinworms and patients also need to do a thorough washing of their bedding and clothing.

00:35 It's also important to treat the entire family. Now, let's delve deeper.

00:39 Pinworms. This is a small, thin, white, roundworm called Enterobius vermicularis.

00:45 It's most common in children and institutionalized people, and household contacts of patients can also have pinworm infection.

00:53 The life cycle from egg to adult takes place in the human GI tract of a single human host and the maturity takes 2-8 weeks.

01:02 So how is this transmitted? Well, it's human to human transmission by ingesting infectious eggs.

01:08 This is transmitted via the fecal-oral route and eggs can survive up to 3 weeks in a moist environment.

01:14 The surface of the eggs is very sticky so it's easily transmitted to fingernails, hands, pajamas, and bed linens.

01:22 The eggs are then transmitted to food, water, furniture, toys, bathroom fixtures, and any fomite around the house. Pets can also carry the eggs in their fur.

01:33 And this is a problem when patients are doing their laundry and they shake out their linen.

01:37 They can actually spread these eggs in the dust and then inhale and swallow these later.

01:42 Here you see the pinworm life cycle. It starts with the little girl in the middle.

01:45 She's gonna have eggs emerging from her anus and this is gonna cause itching so she's gonna start scratching.

01:51 She's gonna contaminate her hands with these fertile eggs and then she might eat something.

01:56 Have a snack or put her hands on her mouth and she's gonna swallow and this is going to persist.

02:00 Then she'll have a friend over to play and they'll be playing with toys, touching the same toys, and she'll transmit this infection to her friend.

02:08 So pinworms. They're typically found in the cecum, the appendix, and the adjacent areas of the ileum and the ascending colon.

02:14 Gravid females, pregnant females, are gonna migrate at night to the perianal and perineal regions where they can lay up to 10,000 eggs while they mature within 6 hours.

02:25 This is gonna start the itching and scratching cycle.

02:28 Then the patient's gonna scratch and these eggs are gonna be ingested by the same host or a friend.

02:34 The larva can hatch in the small intestine and migrate to the colon where they're going to mature and begin this life cycle again.

02:41 Now, typically, there's no damage to the skin and they don't typically extend through the tissues but they can migrate to the vulva and into the vagina, in the uterus, and the fallopian tubes and this can cause vaginal itching.

02:53 They can also migrate up the urethra carrying this intestinal bacteria causing urinary tract infections because remember, the most common cause of urinary tract infection is E. coli and this is normal flora found in the stool.

03:06 This can also invade the appendix but they don't start an inflammatory reaction so it's not currently associated with acute appendicitis.