Acute appendicitis due to infection with Enterobius vermicularis, A case report

INTRODUCTION & IMPORTANCE: Enterobius vermicularis is the most common parasitic infection in developed countries of temperate and cool climates.The feco-oral route is the most common route of human infection. Due to obstruction of appendiceal lumen, the presence of parasites in the appendix may cause appendiceal colic or cause inflammation of the appendix. CASE PRESENTATION: A 17 years old male was referred to our Emergency Department with acute abdominal pain in his right lower quadrant. The physical and laboratory examination revealed right iliac fossa tenderness and leukocytosis with neutophilia. An open appendectomy was performed. The lumen of appendix was filled with pinworms and were moved out of the appendiceal lumen. Postoperatively, one oral dose of 100 mg of mebendazole was administered to our patient and his family members and was repeated after 14 days. CONCLUSION: Infrequently the E. vermicularis can be found in appendectomy pathological specimens. Rarely, acute appendicitis caused by parasitic infections, especially in adults. So the clinical signs of intestinal parasite infection can be may mimic acute appendicitis. A careful evaluation of symptoms such as pruritus ani, or eosinophilia on laboratory examination, could prevent unnecessary appendectomies.