Enterobius vermicularis infection in congenital anorectal malformation

Abstract

Introduction: Enterobius vermicularis (pinworm) infections are prevalent worldwide, particularly among children, and are sometimes associated with surgical conditions such as appendicitis. We present a case of pinworm infection in a child with a congenital anorectal malformation, discussing its association with other surgical conditions.

Case report: A 12-year-old boy was admitted with abdominal pain and chronic malnutrition. His history included crampy abdominal pain, peri-anal itching, and constipation for the past 10 years. Diagnosed with an anorectal malformation at birth, he had undergone a colostomy followed by anorectoplasty for a rectourethral fistula. Currently, he presented with an anal stricture, which was treated with stricturoplasty. During surgery, small worms were observed in the anal corrugations, identified as E. vermicularis. He was treated with albendazole and was free of pinworm infection at a six-week follow-up. His abdominal pain and constipation also resolved.

Conclusion: The overlapping symptoms of E. vermicularis infection with other surgical conditions may lead to a delayed diagnosis, adversely affecting growth and development of the patients. A high index of clinical suspicion of parasitic infections in presence of associated symptoms may lead to an early diagnosis and better patient outcomes.