Pinworm infection is caused by Enterobius vermicularis, a small white worm common in school-age children and their families. The female worm lays eggs around the anus at night, which causes itching and spreads easily by hands and bedding.
Key symptoms
- Itching around the anus, worse at night
- Restless sleep and irritability
- Vulvar itching or irritation in girls
- Many children have no symptoms
What you find on exam
- Scratch marks or irritated skin around the anus
- Small white threadlike worms seen at night
- Symptoms in other household members
Tests
- Tape test: clear tape pressed on the anal skin first thing in the morning, 3 days in a row
- Microscope look at the tape for eggs
- Stool tests are not useful
Treatment basics
- Single dose of albendazole, mebendazole or pyrantel pamoate, repeated in 2 weeks
- Treat the whole household at the same time
- Hand washing and short, clean nails
- Morning bathing and hot washing of bedding and underwear
Red flags
- Abdominal pain with fever
- Vaginal discharge or urinary symptoms in girls
- Weight loss or blood in the stool (look for another cause)
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Sources: NCCPA PANCE Content Blueprint; NBOME COMLEX-USA clinical presentations; CDC, Hand Hygiene in Healthcare Settings. Written by Making Synapses. Making Synapses is not affiliated with these organizations.