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Reliable, easy-to-read patient information on common medical conditions — written in plain language, free of jargon, and grounded in current evidence. Browse the most frequent diagnoses, understand what they mean for everyday life, and learn which steps and questions help you have a focused conversation with your doctor.

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Enterobiasis differential diagnosis

Introduction

Overview

Overview

Enterobiasis must be differentiated from other diseases causing pruritis ani such as seborrheic dermatitis, atopic dermatitis, contact dermatitis, skin infections, anal fissure and the nematode infections like ascariasis, ancylostomiasis, and strongyloidiasis.

Differentiating Enterobiasis from other diseases

Differentiating Enterobiasis from other diseases

Enterobiasis should be differentiated from various other causes of anal pruritus and from other nematode infections.

Differentiating Enterobiasis from other causes of Anal Pruritis

The table below summarizes other major causes of pruritus ani (anal pruritus).[1][2]_ASCRS-3|[3]

Causes Suggestive findings Diagnostic approach Treatment
Skin

infections

Bacterial
  • Skin edema, erythema, and warmth.
  • Pruritus, pain, and discharge from the lesions.
  • Physical examination reveals local inflammatory findings
  • Culture/sensitivity of discharge
Candidal
  • Erythematous skin plaques and erosions with peripheral scaling.
  • Pruritus on the skin plaques.
  • KOH preparation of skin scrapings
Scabies
  • Erythematous papules with hemorrhagic crustings.
  • Pruritus, pain, and bleeding from papules.
  • Identification of eggs on skin scrapings
HPV

(Condylomata

acuminata)

  • Soft papules/plaques in the anogenital area.
  • Pruritus, pain, and bleeding from papules.
Other skin diseases Atopic dermatitis
  • Scaly, erythematous, pruritic and skin lesions.
  • Physical examination
Seborrheic dermatitis
  • Erythematous, yellow, oily plaques
  • Mild pruritus
  • Physical examination
Contact dermatitis
  • Erythematous, pruritic skin lesion
  • Physical examination
Lichen planus
Lichen sclerosus
Perianal carcinoma (Bowen disease or Paget’s disease)
  • Surgery
Anorectal

Disorders

Inflammatory bowel disease
  • Abdominal pain
  • Diarrhea (secretory, mucoid,or bloody)
  • Weight loss
  • Perianal pruritis
Hemorrhoids (internal or external)
  • Bright red blood on toilet paper/stool
  • Pain with defecation
  • Painful lump in the anal area
  • Perianal pruritis
Anal fissure
  • Bright red blood on toilet paper/stool
  • Pain with defecation
  • Perianal pruritus
  • Anal tears
  • Physical examination reveals anal lacerations.
Hygiene

Related problems

Excessive sweating and Poor cleaning
  • Wearing tight undergarments or synthetic clothes.
  • Exclusion of medical causes
  • Use of cotton undergarments.
  • Frequently changing undergarments.
Meticulous cleansing of anal area
  • Inappropriate cleaning practices
  • Exclusion of medical causes
  • Patient education and change of practice.
Skin irritants
  • Use of ointments, soaps, and sanitary wipes.
  • Exclusion of medical causes

Differentiating Enterobiasis from other nematode infections

The table below summarizes the findings that differentiate enterobiasis from other nematode infections.

Differentiating enterobiasis from other Nematode infections[4][5][6]
Infection Nematode Transmission Direct Person-Person Transmission Duration of Infection Pulmonary Manifestation Location of Adult worm(s) Treatment
Enterobiasis Enterobius vermicularis

(pinworm)

Ingestion of infective ova Yes
  • 1-month
  • Extraintestinal migration is very rare
 Free air in the lumen of cecum, appendix, adjacent colon
Strongyloidiasis Strongyloides stercoralis Filariform larvae penetrate skin or bowel mucosa Yes
  • Lifetime of the host
 Embedded in the mucosa of the duodenum, jejunum
Trichuriasis Trichuris trichiura

(whipworm)

Ingestion of infective ova No 1-3 years
  • No pulmonary migration, therefore, no pulmonary manifestation
 Anchored in the superficial mucosa of cecum and colon
Ascariasis Ascaris lumbricoides Ingestion of infective ova No 1-2 years Free air in the lumen of the small bowel

(primarily jejunum)

Hookworm infection Necator americanus and Ancylostoma duodenale Skin penetration by filariform larvae No Attached to the mucosa of mid-upper portion of the small bowel

References

  1. ↑ Siddiqi S, Vijay V, Ward M, Mahendran R, Warren S (2008). “Pruritus ani”. Ann R Coll Surg Engl. 90 (6): 457–63. doi:10.1308/003588408X317940. PMC 2647235. PMID 18765023.
  2. ↑ Fleshman, James (2007). The ASCRS textbook of colon and rectal surgery. New York, NY: Springer. ISBN 978-0-387-36374-5.
  3. _ASCRS_3-0|↑ [+https://www.fascrs.org/patients/disease-condition/pruritis-ani-expanded-version “Pruritis Ani Expanded Version | ASCRS”] Check |url= value (help).
  4. ↑ Durand, Marlene (2015). “Chapter 288:Intestinal Nematodes (Roundworms)”. Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases Updated Edition, Eighth Edition. Elsevier. pp. 3199–3207. ISBN 978-1-4557-4801-3.
  5. ↑ Kim, Kami; Weiss, Louis; Tanowitz, Herbert (2016). “Chapter 39:Parasitic Infections”. Murray and Nadel’s Textbook of Respiratory Medicine Sixth Edition. Elsevier. pp. 682–698. ISBN 978-1-4557-3383-5.
  6. ↑ Serpytis M, Seinin D (2012). “Fatal case of ectopic enterobiasis: Enterobius vermicularis in the kidneys”. Scand J Urol Nephrol. 46 (1): 70–2. doi:10.3109/00365599.2011.609834. PMID 21879805.

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Furqan M M. M.B.B.S[2]