暂无摘要。

Background: The role of Enterobius vermicularis infestation in the context of appendicitis is largely overlooked, but Enterobius vermicularis is considered an unexpected and significant appendicectomy finding. The aim of this study was to investigate the frequency of Enterobius vermicularis findings in appendectomies and to evaluate the clinical and histopathologic features of patients with Enterobius vermicularis-associated acute appendicitis and those with appendiceal Enterobius vermicularis infestation. Methods: The medical records of all children who underwent an appendectomy in two large pediatric centers in Croatia between 1 January 2009 and 1 January 2024 were retrospectively reviewed. Of 6359 appendectomies, 61 (0.96%) children were diagnosed with Enterobius vermicularis on histopathology and included in further analysis. The groups were compared with regard to demographic characteristics, laboratory values, clinical features and histopathological findings. Results: The incidence of enterobiasis fluctuated slightly in the individual study years, but was constant overall. The median age of all patients was 11 years (IQR 8.5, 13), with females predominating (60.7%). Acute appendicitis was observed in 34% of the appendiceal species. The patients with Enterobius vermicularis infestation, without appendicitis, were younger (9 years (IQR 8, 13) vs. 12 years (IQR 10, 15); p = 0.020), had longer duration of symptoms (36 h (IQR, 12, 48) vs. 24 h (IQR, 12, 36); p = 0.034), lower body temperature (37 °C (IQR 36.8, 37.4) vs. 37.6 °C (IQR, 37, 38.6) p = 0.012), lower Appendicitis Inflammation Response (AIR) score (3 (IQR 2, 5) vs. 7 (IQR 5, 9.5) p < 0.001), lower incidence of rebound tenderness (57.1% vs. 20%; p = 0.003) and less frequent vomiting (12.5% vs. 47.6%; p = 0.004) compared to the patients with Enterobius vermicularis-associated acute appendicitis. Acute inflammatory markers in the laboratory showed significantly higher values in the group of patients with acute appendicitis: C-reactive protein (p = 0.009), White blood cells (p = 0.001) and neutrophils (p < 0.001). Eosinophilia was not found in any of the groups, although eosinophil counts were significantly higher in children who had Enterobius vermicularis infestation than in those with Enterobius vermicularis-related appendicitis (2.5% (IQR 0.9, 4.3) vs. 1.8% (IQR 0.7, 2.1); p = 0.040). Conclusions: Pediatric surgeons should consider Enterobius vermicularis infestation as a differential diagnosis when removing a vermiform appendix. Younger age, longer duration of symptoms, lower body temperature, lower AIR score, lower diameter of the appendix and normal laboratory inflammatory markers could predict Enterobius vermicularis infection in children presenting with right iliac fossa pain and avoid unnecessary appendectomy.

OBJECTIVE: To investigate the prevalence of Enterobius vermicularis infections among children in China from 2016 to 2021, so as to provide insights into enterobiasis control and formulation of the enterobiasis control strategy among children.
METHODS: Publications pertaining to the prevalence of E. vermicularis infections among children were retrieved from Wanfang Data, CNKI, VIP and PubMed databases published from January 2016 to June 2023. Eligible publications were screened according to inclusion and exclusion criteria, and the publication bias was evaluated using the assessment tool for prevalence studies proposed by the Joanna Briggs Institute Evidence-Based Practice Resources in Australia. The study period, study areas, study subjects, sample size and number of infections were extracted from publications, and a pooled analysis was performed using a meta-analysis. A meta-regression analysis was performed with the prevalence of E. vermicularis infections as an independent variable, and sample size, source of samples, study area, study method, geographical area and province as dependent variables to identify the source of the study heterogeneity.
RESULTS: A total of 66 studies were included, covering 23 provinces (municipalities, autonomous regions) in China, and with the investigations conducted between 2016 and 2021. Meta-analysis showed that the pooled prevalence of E. vermicularis infections was 4.5% [95% confidence interval (CI): (3.1%, 6.0%)] among children in China from 2016 to 2021, and the annual prevalence was 4.1% [95% CI: (2.2%, 6.5%)], 4.2% [95% CI: (2.4%, 6.6%)], 4.2% [95% CI: (2.2%, 6.8%)], 3.2% [95% CI: (1.5%, 5.4%)], 2.3% [95% CI: (0.9%, 4.3%)] and 1.1% [95% CI: (0.4%, 2.1%)] from 2016 to 2021. The pooled prevalence of E. vermicularis infections was 4.9% [95% CI: (3.4%, 6.8%)] in studies with a sample size of < 5 000 cases, which was higher than that in studies with a sample size of 5 000 cases and higher [2.1%, 95% CI: (0.2%, 3.6%)], and the pooled prevalence of E. vermicularis infections was 5.2% [95% CI: (2.9%, 8.2%)] among subjects from schools, which was higher than that among subjects from communities [4.2%, 95% CI: (2.7%, 6.0%)]. The pooled prevalence of E. vermicularis infections was 4.4% [95% CI: (2.8%, 6.2%)] among children included in comprehensive surveillance, which was higher than that among children included in specific surveillance [4.8%, 95% CI: (2.6%, 7.7%)], and the pooled prevalence of E. vermicularis infections was 5.7% [95% CI: (3.8%, 7.8%)] among children included in county-level surveys, which was higher than that among children included in city-[4.8%, 95% CI: (2.3%, 8.0%)] and province-level surveys [1.8%, 95% CI: (0.3%, 4.7%)]. In addition, the pooled prevalence of E. vermicularis infections was higher among children in southern China [11.3%, 95% CI: (7.5%, 15.7%)] than that in central China [5.2%, 95% CI: (2.8%, 8.2%)], eastern China [5.2%, 95% CI: (2.8%, 8.2%)] and southwestern China [2.6%, 95% CI: (1.4%, 4.1%)]. Meta-regression analysis identified geographical area and survey province as factors affecting the study heterogeneity.
CONCLUSIONS: Currently, the overall prevalence of E. vermicularis infections is moderate among children in China, and the prevalence varies greatly in regions, with a high prevalence rate in southern China and presence of small-scale clusters. Enterobiasis surveillance and health education pertaining to enterobiasis control are required with adaptations to local circumstance to reduce the prevalence of E. vermicularis infections among children.
［摘要］ 目的 分析 2016—2021 年我国儿童蛲虫感染率, 为儿童蛲虫病防控及防治策略制定提供科学依据。方法 在 万方数据库、中国期刊全文数据库、维普网、PubMed 数据库中, 检索 2016 年 1 月至 2023 年 6 月公开发表的关于我国儿童 蛲虫感染率的文献。根据纳入排除标准筛选文献, 采用澳大利亚乔安娜布里格斯研究所循证卫生保健中心患病率研究 评价工具进行文献偏倚风险评价。提取纳入文献中的调查时间、调查范围、研究对象、样本量和感染例数等数据, 采用 meta分析进行合并分析。以感染率为自变量, 样本量、样本来源、调查范围、调查方式、地理区域、省份作为因变量进行 meta回归分析, 探讨研究异质性来源。结果 共纳入 66 篇文献进行分析, 研究范围覆盖我国 23 个省 (直辖市、自治区), 调查时间为 2016—2021 年。Meta分析结果显示, 2016—2021 年我国儿童蛲虫合并感染率为4.5% [95% 可信区间 (confidence interval, CI): (3.1%, 6.0%)], 各年感染率分别为4.1% [95% CI: (2.2%, 6.5%)]、4.2% [95% CI: (2.4%, 6.6%)]、4.2% [95% CI: (2.2%, 6.8%)]、3.2% [95% CI: (1.5%, 5.4%)]、2.3% [95% CI: (0.9%, 4.3%)]、1.1% [95% CI: (0.4%, 2.1%)]。样 本量< 5000 例的研究儿童蛲虫合并感染率为 4.9% [95% CI: (3.4%, 6.8%)], 高于样本量 ≥ 5 000 例的研究 [2.1%, 95% CI: (0.2%, 3.6%)]; 调查对象来源于学校的研究合并感染率为 5.2% [95% CI: (2.9%, 8.2%)], 高于来源于社区的研究 [4.2%, 95% CI: (2.7%, 6.0%)]; 监测类型为综合监测的研究合并感染率为 4.4% [95% CI: (2.8%, 6.2%)], 低于专项监测研究 [4.8%, 95% CI: (2.6%, 7.7%)]; 调查范围为县 (区) 级的研究合并感染率为 5.7% [95% CI: (3.8%, 7.8%)], 高于调查范围 为地市级 [4.8%, 95% CI: (2.3%, 8.0%)] 和省级的研究 [1.8%, 95% CI: (0.3%, 4.7%)]。华南地区儿童蛲虫感染率 [11.3%, 95% CI: (7.5%, 15.7%)] 高于华中 [5.2%, 95% CI: (2.8%, 8.2%)]、华东 [5.2%, 95% CI: (2.8%, 8.2%)] 与西南地区 [2.6%, 95% CI: (1.4%, 4.1%)]。Meta 回归分析结果显示, 地理区域和调查省份为研究异质性的影响因素。结论 目前 我国儿童蛲虫感染总体处于中度流行水平, 不同地区感染率差异较大, 华南地区感染率较高, 且感染存在小范围聚集现 象。各地应因地制宜开展监测和健康教育等工作, 以进一步降低儿童蛲虫感染率。.

UNASSIGNED: Here we present a case of a 4-year-old girl who suffered from vulvovaginitis caused by Enterobius vermicularis. All members of her family were also infected by this helminth. Treatment with mebendazole was administered to all family members and it was found that the entire family had been cured.
UNASSIGNED: Vulvovaginitis, an inflammation of the vulvovaginal mucous membranes, is a common reason for pediatric gynecology consultations. One of the causes of this condition is a parasitic worm known as Enterobius vermicularis (E. vermicularis). In girls, adult worms can infiltrate the vagina and release eggs, leading to the development of vulvovaginitis. Furthermore, these worms have the ability to invade the endometrial cavity too. Here we present a case of a 4-year-old girl who suffered from vulvovaginitis caused by E. vermicularis. All members of her family were also infected by this parasitic helminth. In the vaginal sample, apart from the eggs, the female adult worm was observed under the microscope. Treatment with mebendazole was administered to all family members, and their progress was followed for a period of 3 weeks, during which it was found that the entire family had been cured. This patient experienced significant improvement in symptoms related to severe anxiety, nervousness, vaginal inflammation, itching, and vulvovaginitis caused by E. vermicularis. To prevent infection by E. vermicularis, it is crucial to disinfect underwear and bed sheets. In kindergartens, the spread of this parasite should not be underestimated, and asymptomatic individuals who have been exposed to infected persons should receive treatment to prevent an epidemic. Maintaining cleanliness and hygiene, especially after using the toilet, is of the most importance, particularly for girls who are more susceptible to E. vermicularis infection. Additionally, it is essential for all family members to be aware of the transmission routes of this parasite.

暂无摘要。

Pinworm infection (known as enterobiasis or oxyuriasis) is one of the most common parasitic diseases globally and in the Czech Republic (CZ). The aim of this study is to analyse the available epidemiological data on the incidence of enterobiasis in the CZ from 2018-2022.
A descriptive analysis was done of enterobiasis (ICD-10 code B80) data reported to the electronic Infectious Disease Information System in the CZ from 2018 to 2022. Data processing and analysis were conducted using MS Excel 2016. Univariate and multivariate logistic regression analyses were performed to assess the association between the probability of hospitalization and categorical variables using STATA version 17. The ECDC Map Maker tool (EMMa) was used to create the incidence map.
A total of 4,836 cases were reported during the study period, with an average annual incidence of 9.1 cases per 100,000 population. The highest number of cases occurred in 2019 (n = 1,174), and the lowest in 2021 (n = 780). The disease was most common in the paediatric population, with the highest average age-specific incidence rates observed in children aged 5-9 years (80.9 per 100,000 population) and 10-14 years (42.3 per 100,000 population). Of 14 administrative regions of the CZ, the Olomouc Region had the highest average annual incidence (28.7 per 100,000 population), while the Pilsen Region had the lowest (2.2 per 100,000 population). A total of 472 (9.8%) patients needed hospitalization, most of them in the categories 10-14 years (n = 200, 42.4%) and 5-9 years (n = 178, 38%). The highest hospitalization rate was found in the age group 75+ (36.4%). A significantly higher probability of hospitalization was found in the age groups 6-19 years and 65+ compared to working-age population with enterobiasis. A significantly lower probability of hospitalization was seen in 2020-2022 compared to 2019. No difference in the hospitalization rates was noted between genders. No enterobiasis-related death was reported during the study period. The disease occurs year-round. A decrease in reported cases was observed annually during the school summer holidays in July and August. Neither outbreak nor imported cases were noted.
Given that enterobiasis is often asymptomatic, many cases are not captured in the surveillance system. The Czech prevalence data indicate that it mainly affects the paediatric population. Therefore, preventive measures and programs should primarily target children.

BACKGROUND: Enterobius vermicularis (E. vermicularis), also referred to as pinworm, is a widespread human intestinal parasite which predominantly occurs in young children, making their caretakers a population at risk for the transmission of this helminth. It can occasionally affect extraintestinal organs and tissues, including the female genital tract. Infestation can be asymptomatic or manifest as different kinds of gynaecological disorders, such as pelvic inflammation mimicking tumours, abnormal uterine bleeding, or vaginitis. Diagnosis is made by identifying ova in the sample collected from the perineal skin using a transparent adhesive tape or microscopic examination of resected tissue. Mebendazole is the first-line medication and should also be administered to all household members.
METHODS: We present a case of a patient who had undergone surgery for invasive cervical cancer with an accidental finding of E. vermicularis eggs in the cervix.
CONCLUSIONS: Although not very common, infestation with E. vermicularis should be considered in differential diagnoses of various gynaecological disorders accompanied by histological findings of granulomatous inflammation.

BACKGROUND: The aim of this study was to determine and compare the miRNA profile in the immune response with the parasite in pediatric patients with acute appendicitis caused by Enterobius vermicularis and in pediatric patients with enterobiasis.
METHODS: A total of 30 tissue samples, which were operated with the diagnosis of pediatric acute appendicitis in the last 10 y and Enterobius vermicularis was detected by histopathological findings, were analyzed. In addition, blood samples were taken from 30 pediatric patients diagnosed with enterobiasis for this study. The miRNAs that activate T and B cells were evaluated by a quantitative real-time PCR, statistically calculated within ΔΔCt values, and fold changes were evaluated by Welch\'s T test, in which p<0.5 was considered to be significant.
RESULTS: It was found that 48 out of 136 (35.3%) miRNAs differed between the pediatric patient and healthy control groups. It was determined that 22 (57.9%) of the different miRNAs were T cell activating miRNAs and 26 (68.4%) were B cell activating miRNAs. While there was a significant difference in miRNA values activating T cells in two patient groups (p<0.01), there was no significant difference in miRNA values activating B cells (p>0.01).
CONCLUSIONS: In the study, although Enterobius vermicularis was the causative agent in both patient groups, it was revealed that the immune response of patients with acute appendicitis was more affected than enterobiasis patients.

BACKGROUND: Acute appendicitis is a common health problem mainly due to a lumen obstruction. The obstruction is mainly due to fecal material, lymphoid hyperplasia or parasites. Foreign bodies and especially seeds have been rarely reported as causes of acute appendicitis and account for less than 1% of the different causes.
METHODS: The authors described a rare case of acute appendicitis caused by seed and causing diagnostic challenge with the most frequent parasites observed in the appendix lumen. Different arguments were gathered to rule out enterobius vermicularis, taenia species, ascaris infection or schistosomiasis.
CONCLUSIONS: Seed-caused-appendicitis has to be known and identified by pathologists in order to avoid the diagnosis of parasites infection which may induce an overuse of antibiotics after the appendectomy.

Pinworm infestation is an important public health problem worldwide, especially among children 5 to 10 years of age in developing countries with temperate climates. The problem is often overlooked because of its mild or asymptomatic clinical manifestations.
The purpose of this article was to familiarize pediatricians with the diagnosis and management of pinworm infestation.
A search was conducted in August 2023 in PubMed Clinical Queries using the key terms \"Enterobius vermicularis,\" OR \"enterobiasis,\" OR \"pinworm.\" The search strategy included all clinical trials, observational studies, and reviews published within the past 10 years. Only papers published in the English literature were included in this review. The information retrieved from the above search was used in the compilation of the present article.
Enterobiasis is a cosmopolitan parasitosis caused by Enterobius vermicularis. It affects approximately 30% of children worldwide and up to 60% of children in some developing countries. Predisposing factors include poor socioeconomic conditions, inadequate sanitation, poor personal hygiene, and overcrowding. Children aged 5 to 14 years have shown the highest prevalence of enterobiasis.. Egg transmission is mainly by the fecal-oral route. Approximately 30 to 40% of infested patients do not show any clinical symptoms of the disease. For symptomatic patients, the most common presenting symptom is nocturnal pruritus ani. The diagnosis of E. vermicularis infection is best established by the cellophane tape test. The sensitivity of one single test is around 50%; however, the sensitivity increases to approximately 90% with tests performed on three different mornings. If a worm is visualized in the perianal area or the stool, a pathological examination of the worm will yield a definitive diagnosis. As pinworms and eggs are not usually passed in the stool, examination of the stool is not recommended. The drugs of choice for the treatment of pinworm infestation are mebendazole (100 mg), pyrantel pamoate (11 mg/kg, maximum 1 g), and albendazole (400 mg), all of the above-mentioned drugs are given in a single dose and repeated in two weeks. Mebendazole and albendazole are both adulticidal and ovicidal, whereas pyrantel pamoate is only adulticidal. Given their safety and effectiveness, mebendazole and albendazole are currently the best available drugs for the treatment of pinworm infestation. For pregnant women, pyrantel is preferred to mebendazole and albendazole. Treatment of all household members should be considered, especially if there are multiple or repeated symptomatic infections because reinfection is common even when effective medication is given.
In spite of effective treatment of pinworm infestation, recurrences are common. Recurrences are likely due to repeated cycles of reinfection (particularly, autoinfection) because of the short life span of adult pinworms. Good personal hygiene, such as frequent handwashing, especially after bowel movements and before meals, clipping of fingernails, avoidance of finger-sucking, nail-biting, and scratching in the anogenital area, are important preventive measures. Treatment of all household members should be considered, especially if there are multiple or repeated symptomatic infections.