Enterobius vermicularis-induced atypical acute appendicitis in a pediatric patient: a case report from Pakistan
Enterobius vermicularis-induced atypical acute appendicitis
DOI:
https://doi.org/10.52442/jrmi.v12i3.1126Keywords:
Appendicitis, Enterobius Vermicularis, Helminthiasis, Perianal PruritisAbstract
The role of Enterobius vermicularis in triggering appendicitis remains controversial as an incidental finding or actual etiology. Its clinical symptoms mimic acute appendicitis characterized by sudden severe abdominal pain with nausea and vomiting. The appendiceal histoarchitecture often depicts reactive lymphoid hyperplasia marking the parasite presence as a questionable etiology. We report the case of an 11-year-old boy presenting with right lower quadrant abdominal pain and perianal itching. Examination revealed positive guarding and tenderness. Biochemical markers were normal. Abdominal ultrasound suggested parasitic infestations in the appendiceal lumen. Open appendectomy revealed an inflamed tissue with lumen obstructed by helminths. Postoperative standard antibiotic cover with albendazole was administered. This case emphasizes E. vermicularis as an etiology of atypical acute appendicitis and highlights the need for early recognition and management of such patients.
References
Sousa J, Hawkins R, Shenoy A, Petroze R, Mustafa M, Taylor J, et al. Enterobius vermicularis-associated appendicitis: a 22-year case series and comprehensive review of the literature. J Pediatr Surg. 2022;57(8):1494-1498. DOI: 10.1016/j.jpedsurg.2021.09.038.
Harumatsu T, Baba T, Orokawa T, Sunagawa H, Ieiri S. A rare case of acute appendicitis with Enterobius vermicularis. Pediatr Int. 2022;64(1):e15195. DOI:10.1111/ped.15195.
Pogorelić Z, Babić V, Bašković M, Ercegović V, Mrklić I. Management and incidence of Enterobius vermicularis infestation in appendectomy specimens: a cross-sectional study of 6359 appendectomies. J Clin Med. 2024;13(11):3198. DOI: 10.3390/jcm13113198.
Razzaghi M, Rezaei H, Mohammadi F, Salehi AM. Enterobius vermicularis in the appendiceal lumen: a case report. Case Rep Surg. 2024; 2024:7806541. DOI: 10.1155/2024/7806541.
Kauffman ZS, Stuart DL. A case of appendiceal pinworms in an adolescent patient. Cureus. 2025;17(4):e82714. DOI: 10.7759/cureus.82714.
Mohtasebi S, Shokripour M, Vahid PA, Mikaeili F, Abbaszadeh Afshar MJ, Alimi R, Goudarzi F, Teimouri A. Parasitological and histopathological features of appendectomy specimens in Fars Province, southern Iran: a retrospective study. Ann Med Surg (Lond). 2023; 85:1601-6. DOI: 10.1097/MS9.0000000000000208.
Chhetri S, Al Mamari AH, Al Awfi MM, Al Khaldi NHN, Abed NM, Pandak N, et al. Enterobius vermicularis-related acute appendicitis: a case report and review of the literature. Infect Dis Rep. 2023;15(4):417-24. DOI: 10.3390/idr15040042.
Jawabreh I, Amro A, Azmi K, et al. Enterobius vermicularis (pinworm) infestation mimicking acute appendicitis in two children from Palestine: a case report. J Med Case Rep. 2024; 18:445. DOI: 10.1186/s13256-024-04785-9.
Zahoor MI, Bajunaid AM, Aseeri HS, Imran AF. Spillage of pinworms during laparoscopic appendectomy. King Khalid Univ J Health Sci. 2026;10(2):180-183. DOI: 10.4103/KKUJHS.KKUJHS_26_25.
Al-Mufargi Y, Al Musalhi K, Khalil M, et al. Enterobius vermicularis as an intraoperative surprise in a child with suspected appendicitis and normal laboratory findings. Cureus. 2025;17(10): e94036. DOI: 10.7759/cureus.94036.
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Journal of Rehman Medical Institute

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
This is an Open Access article distributed under the terms of the Creative Commons Attribution-Non Commercial License (http://creativecommons.org/licenses/by-nc/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
