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Children's Health

Perianal Itchiness May Indicate Pinworm Infection

Pinworm or Enterobius vermicularis infection is the most common intestinal worm infection in the United States. They are white, glistening worms about half an inch long. Pinworms live in the rectum predominantly. Female pinworms come out of the anus at night and lay eggs on the infected person's perianal region. Unfortunately for females, they may also infect the vagina and cause a discharge as well as intense perianal itching. Left untreated, they can definitely multiply to the point of causing frequent stooling and even diarrhea.

They are most often acquired by children sitting on and playing in sand or dirt where infected animals have passed stool that has transferred the pinworms to the sand or soil. Because children are not usually conscientious handwashers, it is easy for the worms to become lodged under the nails and transferred to the intestines when eating with poorly washed hands.

Mothers often contract the worms from their children because they help with toileting and handle their soiled clothing and bedding. Mothers who are rushing from task to task can forget to wash their hands as often or as thoroughly as they need to to protect themselves.

The infection can be diagnosed from stool samples or by applying a piece of transparent tape across your child's anus at bedtime. As the worms come out to lay eggs in the night, some will adhere to the tape. Many pediatric providers diagnose the infection by history, but some will want proof of the problem.

Happily, several medications are available to effectively treat the infection. One of the most common prescription medications is mebendazole, also known as Vermox. Reese's Pinworm Medicine, Pin-X, and Pin-Rid are three possible medications available over the counter. Side effects of all these medications include

The infected child and all family members should be treated. Many providers recommend a second dose 7 days later to assure that any worms hatching from eggs after the first treatment are destroyed. Occasionally, a serious infection may require a third round of treatment three weeks later. Most of the available medications are small tablets that are easy to take. A vaginal and strong perianal infection may also require topical treatment.

Hygienic measures to assure successful treatment include daily changing and washing of all underclothing, clothing, bed linens, and towels; daily toilet cleansing; and frequent handwashing.

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Last Reviewed: May 18, 2009

Mary M Gottesman, PhD, RN, CPNP, FAAN Mary M Gottesman, PhD, RN, CPNP, FAAN
Professor of Clinical Nursing
College of Nursing
The Ohio State University