Preschool children in the Kingdom of Eswatini are excluded from the national school-based deworming programme and had never been surveyed for parasitic infection. During June 2019 we conducted a cross-sectional baseline survey of 261 children (mean age 4.8 ± 0.75 years) attending 16 kindergartens and community care points across 4 provinces. Enterobius vermicularis was sought on peri-anal cellophane/Scotch-tape swabs (n = 261); Schistosoma haematobium in single urine specimens by the chamber-tube microscope-slide (CTMS) sedimentation method (n = 232); and intestinal helminths and protozoa in single stool specimens by the merthiolate-iodine-formaldehyde (MIF) concentration method (n = 175). Pinworm prevalence was 3.8% (10/261) and did not differ by sex (p = 0.76) or province (p = 0.83). S. haematobium ova were found in 0.9% (2/232), both in boys from recognised endemic foci. Intestinal parasites were detected in 41.1% (72/175), with no significant sex (p = 0.64) or regional (p = 0.70) variation; protozoa predominated (97.2% of positives) over helminths (4.2%; all Ascaris lumbricoides), the commonest species being Blastocystis hominis (61.1%) and Giardia lamblia (34.7%). These first baseline data reveal a high burden of intestinal protozoa alongside a low but measurable burden of pinworm and urogenital schistosomiasis in Eswatini preschool children, and support extending screening and preventive chemotherapy to this previously unmonitored age group using the simple, field-deployable cellophane-swab, CTMS and MIF methods.

Enterobius vermicularis, also called pinworm, is one of the most common nematode infections in the world. Originally, E. vermicularis was named Oxyuris vermicularis. Humans are the only natural host for this infection. Transmission occurs in people who are living in crowded environments and usually occurs within families. The worms are tiny, thread-like, and whitish. The worm is named after the characteristic pin-like tail present on the posterior part of female worms.[1][2] Pinworm infestation usually occurs in children. Transmission is via direct contact with contaminated items or even during sexual contact. Most infections are asymptomatic. While the cure rate is high, recurrences are common.

Enterobius vermicularis is the most common nematode infection in the United States. Despite this prevalence, few studies have evaluated current clinical practices with regard to diagnosis and management. Price increases in anthelmintics in the United States add a component of cost-conscious care to treatment selection. We conducted a retrospective analysis of 200 patients in the Military Health System with an International Classification of Diseases code diagnosis of enterobiasis from 2011 to 2018. A clinical diagnosis was made in 70.0% of symptomatic patients. A pinworm paddle or cellophane adhesive was ordered in 12.7% of symptomatic cases, with a positivity rate of 41.2%. Diagnostic studies ineffective for the diagnosis of enterobiasis were ordered in 12.0% of symptomatic cases, with the most common being ova and parasite examinations of the stool (10.0%). The most common initial treatment of enterobiasis was albendazole (73.6%) followed by mebendazole (15.0%), pyrantel (10.9%), and ivermectin (0.5%). Empiric retreatment of patients after initial treatment and empiric treatment of household members were prescribed or recommended in 86.0% and 49.7% of cases, respectively. Counseling on decontamination measures to prevent reinfection was documented in 35.2% of cases. This study suggests that there are knowledge gaps in the optimal diagnostic approach to enterobiasis as well as the role of adjunctive measures to prevent a cycle of continuous reinfection, such as empiric retreatment, empiric treatment of household members, and counseling on decontamination measures. Additionally, the prominence of albendazole use relative to pyrantel pamoate represents an opportunity for cost-conscious care.

A 12-year-old premenarchal female patient presented with right iliac fossa pain, perianal pruritus, urticaria, angioedema, arthralgia, peripheral eosinophilia, and an initially undetectable C-reactive protein. Serial ultrasonography demonstrated increasing intra-abdominal free fluid. Diagnostic laparoscopy demonstrated appendiceal serosal injection, turbid pelvic fluid, and mesenteric lymphadenopathy, prompting appendectomy. Histopathology identified Enterobius vermicularis (EV) within the appendiceal lumen, with reactive lymphoid hyperplasia but no acute suppurative inflammation. Symptoms resolved following surgery and mebendazole treatment. A descriptive updated systematic review of appendectomy specimens containing EV was performed. Seventy-six studies comprising 196,138 appendectomy specimens were included. EV was identified in 3,913 specimens, corresponding to a crude proportion among appendectomy specimens of 2.00% (95% CI: 1.93-2.06%). Among 11 newly identified studies reporting histological subclassification, 247 of 694 EV-positive specimens (35.6%) demonstrated histological acute appendicitis, whereas most showed non-suppurative or reactive pathology. This case and review suggest that appendiceal enterobiasis may present as an appendicitis-like illness, particularly when abdominal pain occurs alongside atypical features such as perianal pruritus, eosinophilia, urticaria, or angioedema. Recognition of enterobiasis may guide anthelmintic therapy and consideration of household treatment; however, a causal relationship between EV and systemic hypersensitivity features cannot be established from a single case. Importantly, clinical deterioration should continue to prompt urgent surgical assessment.

Small bowel involvement of Enterobius vermicularis infection is exceptionally rare, with few cases reported. A female presented with persistent abdominal pain for one month. Gastroscopy and colonoscopy were unremarkable, but computed tomography revealed localized small bowel wall thickening. Laboratory tests showed elevated eosinophil counts, though parasite antibody screening was negative. Double-balloon enteroscopy identified multiple shallow ulcers and a live worm in the small intestine, confirmed as Enterobius vermicularis on pathological examination. The patient was treated with anthelmintic therapy, and her symptoms resolved without recurrence.

The purpose of this study was to ascertain the status and patterns of pinworm Enterobius vermicularis infection among preschool children in Jeollanam-do from 2023 to 2025. Further, it aimed to assess changes in infection rates during the implementation of the test-and-treatment strategy. Cellophane tape swabs were collected from 12,608 children aged 0-6 years enrolled in daycare or kindergarten facilities in 8 cities and counties of Jeollanam-do. The samples were examined under a light microscope to diagnose pinworm infection. The overall infection rate over the 3-year period was 0.22% (28/12,608). The annual infection rate declined continuously from 0.35% in 2023 to 0.06% in 2025 (trend P<0.05). The infection rate did not vary significantly with sex (P>0.05), but was significantly higher in the 4-6 year age group (P<0.05), and was highest in Jangheung-gun (0.65%) and Goheung-gun (0.37%). The overall infection rate in this study was substantially lower than previously reported. However, this may represent a transient phenomenon reflecting environmental or behavioral factors associated with this specific period. Therefore, continuous monitoring is necessary.

Enterobiasis (pinworm infection), caused by the nematode Enterobius vermicularis, remains among the most common helminth infections worldwide and disproportionately affects children and caregivers in households and institutional settings. Despite its high prevalence, practical guidance is often fragmented across primary care, pediatrics, and public-health sources. We conducted a SANRA-guided, clinician-oriented narrative review synthesizing evidence on the epidemiology and psychosocial burden of enterobiasis, transmission dynamics in households and educational settings, best available diagnostic and therapeutic strategies (including recurrent disease), and context-specific considerations relevant to the Gulf region. We included 27 sources published between January 2015 and December 2025. Across the literature, three consecutive early-morning perianal tape tests consistently outperformed stool ova-and-parasite examinations. Standard two-dose therapy administered 14 days apart (mebendazole, albendazole, or pyrantel pamoate) achieved high cure and egg-negative rates when paired with synchronized household treatment and a right-sized hygiene bundle (morning shower before dressing, nail care, targeted laundering, and hand hygiene coaching). Routine school exclusion is generally unnecessary when treatment has started and the child is otherwise well. Guidance for special populations supports hygiene-first approaches in early pregnancy, with selective pharmacotherapy after the first trimester when needed. For persistent or recurrent symptoms, adherence verification and household coverage remain the first steps; extended ("pulse") regimens may be considered in selected cases, although evidence is based mainly on pragmatic experience and expert consensus rather than randomized trials. The reported association with appendicitis remains inconsistent and should be interpreted cautiously. Overall, family-centered strategies-diagnosis using tape tests, completion of the Day-14 repeat dose, synchronized household treatment, and feasible hygiene-can reduce reinfection cycles and caregiver distress.

Enterobius vermicularis is a common intestinal helminth, whereas extraintestinal disease is rare and may present as a tumor-like lesion. We report a 50-year-old man with common variable immunodeficiency (CVID) and prior right hemicolectomy with adjuvant chemotherapy for cecal adenocarcinoma (pT3N1bM0) who developed a slowly enlarging left-sided cervical mass during oncologic follow-up. The lesion was painless and showed no overlying skin changes. Neck ultrasonography demonstrated a hypoechoic, round mass over the sternothyroid muscle with an elongated hyperechoic compartment and no Doppler flow. Surgical excision was performed; macroscopy suggested a lymph node. Histopathology excluded malignancy and unexpectedly revealed adult Enterobius vermicularis containing eggs embedded within inflammatory stroma. C-reactive protein was mildly elevated without leukocytosis or eosinophilia. Stool examination was negative. Whole-body MRI revealed no other extraintestinal foci. Albendazole was administered in two doses separated by two weeks with clinical resolution; the patient remains under outpatient surveillance. This case highlights that ectopic enterobiasis can mimic cervical lymphadenopathy and metastatic disease, particularly in immunocompromised patients, and that histopathology is critical for diagnosis and management.

Tuberculosis (TB) is an infectious disease and one of the major causes of mortality worldwide, especially in children under the age of 15 years. Abdominal TB includes TB of bowel, peritoneum, lymph nodes, or other solid organs, with a predominance of intestinal and peritoneal forms of the disease. Most pediatric cases may be misdiagnosed due to subclinical symptoms. This case report describes an 11-year-old boy diagnosed with intestinal tuberculosis (ITB) complicated by bowel obstruction. No prior recommendation for surgical therapy resulted in a significant complication of enterobiasis. ITB is a challenging infectious disease associated with high mortality rates, particularly in the pediatric population. This case study emphasizes the importance of pediatric ITB surgery to overcome unfavorable consequences.

Enterobius vermicularis, commonly known as the pinworm, is a prevalent intestinal nematode, particularly affecting children worldwide. Although infection is often asymptomatic, it may occasionally lead to complications, including appendiceal involvement. The role of E. vermicularis in the pathogenesis of acute appendicitis remains controversial and is frequently overlooked. We report a case of a 10-year-old child who presented with intermittent right lower quadrant abdominal pain without fever or systemic symptoms. Initial ultrasound revealed small mesenteric lymph nodes, with no clear evidence of appendiceal pathology. Empirical treatment with antibiotics and anti-inflammatory agents failed to relieve the symptoms. A follow-up ultrasound demonstrated a thickened retrocecal appendix with hypoechoic intraluminal content. Due to persistent pain, a laparoscopic appendectomy was performed, revealing a white, non-segmented roundworm within the appendiceal lumen. Histopathological examination and direct microscopic analysis confirmed follicular appendicitis with intraluminal nematodes morphologically consistent with E. vermicularis. Postoperative parasitological examination further supported the diagnosis, with detection of characteristic eggs using the Scotch tape test, while stool examinations remained negative. These findings suggested E. vermicularis as the most likely etiological agent and supported its pathogenic role in the patient's clinical presentation. The patient was treated with albendazole, followed by a second dose 2 weeks later. Simultaneous treatment was administered to household contacts, and strict hygiene measures were recommended to prevent reinfection. Clinical recovery was complete, with no postoperative complications. This case highlights the importance of considering parasitic infections in the differential diagnosis of acute abdominal pain, even in the absence of systemic inflammatory markers, particularly in endemic or underrecognized settings. Early recognition and targeted therapy are essential to prevent recurrence and intra-familial transmission.