Intense perianal itching in a child. Which infection is most likely?

Intense perianal itching in a child. Which infection is most likely?

• A. Enterobiasis (pinworm)
• B. Hookworm
• C. Ascaris
• D. Strongyloidiasis

Answer: (A)

Intense perianal itching in a child is most commonly caused by pinworm infection. The adult female worms migrate to the anal area at night to lay eggs on the surrounding skin, which provokes itching. Scratching can spread eggs to hands, clothing, and bedding, perpetuating transmission. Diagnosis is often made with a simple anal tape test collected first thing in the morning before washing. Other intestinal worms don’t typically present with prominent perianal itching: hookworms cause a “ground itch” at the site of skin entry and often anemia; Ascaris usually presents with abdominal symptoms or obstruction in heavier infections; Strongyloides can cause GI symptoms and severe illness in certain hosts. Treatment involves an antihelminthic such as mebendazole or albendazole, and it’s important to treat household members and reinforce hygiene—hands, nails trimmed, daily laundering of bedding and clothing—to prevent reinfection.

Intense perianal itching in a child is most commonly caused by pinworm infection. The adult female worms migrate to the anal area at night to lay eggs on the surrounding skin, which provokes itching. Scratching can spread eggs to hands, clothing, and bedding, perpetuating transmission. Diagnosis is often made with a simple anal tape test collected first thing in the morning before washing. Other intestinal worms don’t typically present with prominent perianal itching: hookworms cause a “ground itch” at the site of skin entry and often anemia; Ascaris usually presents with abdominal symptoms or obstruction in heavier infections; Strongyloides can cause GI symptoms and severe illness in certain hosts. Treatment involves an antihelminthic such as mebendazole or albendazole, and it’s important to treat household members and reinforce hygiene—hands, nails trimmed, daily laundering of bedding and clothing—to prevent reinfection.