Other presentations
Occasionally, pinworms may migrate to unusual sites and cause ectopic disease. The most common location for ectopic disease is the female genitourinary tract, where vulvar pruritus (pruritus vulvae) may occur.[1]Kimberlin DW, Barnett ED, Lynfield R, et al, eds. Red Book: 2021-2024 report of the committee on infectious diseases. 32 nd ed. Elk Grove Village, IL: American Academy of Pediatrics; 2021 [internet publication].
https://publications.aap.org/redbook/book/347/chapter-abstract/5755005/Pinworm-Infection-Enterobius-vermicularis
Rarely, pinworms may ascend into the urethra or vagina and may cause urethritis, vaginitis, or salpingitis.[1]Kimberlin DW, Barnett ED, Lynfield R, et al, eds. Red Book: 2021-2024 report of the committee on infectious diseases. 32 nd ed. Elk Grove Village, IL: American Academy of Pediatrics; 2021 [internet publication].
https://publications.aap.org/redbook/book/347/chapter-abstract/5755005/Pinworm-Infection-Enterobius-vermicularis
[2]Shetty JB, Kulkarni DV, Prabhu V. Eggs containing larvae of Enterobius vermicularis in vaginal smear. J Cytol. 2012 Jan;29(1):94-6.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3307469
http://www.ncbi.nlm.nih.gov/pubmed/22438633?tool=bestpractice.com
[3]Choudhury S, Kumar B, Pal DK. Enterobius vermicularis infestation of urinary tract leading to recurrent urinary tract infection. Trop Parasitol. 2017 Jul-Dec;7(2):119-21.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5652050
http://www.ncbi.nlm.nih.gov/pubmed/29114492?tool=bestpractice.com
[4]Pigac B, Mašić S, Mašić V. Enterobius vermicularis in the endometrium of the uterus: a case report. Iran J Parasitol. 2017 Oct-Dec;12(4):638-41.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5756315
http://www.ncbi.nlm.nih.gov/pubmed/29317890?tool=bestpractice.com
[5]Ngui R, Ravindran S, Ong DB, et al. Enterobius vermicularis salpingitis seen in the setting of ectopic pregnancy in a Malaysian patient. J Clin Microbiol. 2014 Sep;52(9):3468-70.
https://journals.asm.org/doi/10.1128/jcm.01191-14
http://www.ncbi.nlm.nih.gov/pubmed/24989613?tool=bestpractice.com
Pinworms have been associated with abscess and granuloma formation within the intestines, along the perineal skin, and within the peritoneum.[1]Kimberlin DW, Barnett ED, Lynfield R, et al, eds. Red Book: 2021-2024 report of the committee on infectious diseases. 32 nd ed. Elk Grove Village, IL: American Academy of Pediatrics; 2021 [internet publication].
https://publications.aap.org/redbook/book/347/chapter-abstract/5755005/Pinworm-Infection-Enterobius-vermicularis
[6]St Georgiev V. Chemotherapy of enterobiasis (oxyuriasis). Expert Opin Pharmacother. 2001 Feb;2(2):267-75.
http://www.ncbi.nlm.nih.gov/pubmed/11336585?tool=bestpractice.com
[7]Rajendran S, Carmody E, Murphy M, et al. Enterobius granulomas as a cause of abdominal pain. BMJ Case Rep. 2015 Aug 18;2015:bcr2015210464.
https://casereports.bmj.com/content/2015/bcr-2015-210464
[8]Bharathi K, Anuradha S, Chandrasekar VA, et al. Enterobius vermicularis worm granuloma mimicking like a pseudo tumor in the anal canal: an unusual clinical presentation. Trop Parasitol. 2012 Jul;2(2):124-6.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3680868
http://www.ncbi.nlm.nih.gov/pubmed/23767020?tool=bestpractice.com
[9]Kılıç S, Ekinci S, Orhan D, et al. Enterobius granuloma: an unusual cause of omental mass in an 11-year-old girl. Turk J Pediatr. 2014 Mar-Apr;56(2):189-91.
https://turkjpediatr.org/article/view/1345
http://www.ncbi.nlm.nih.gov/pubmed/24911856?tool=bestpractice.com
Pinworms have been identified in appendiceal tissue after appendectomy and autopsy, but are not thought to cause acute appendicitis.[1]Kimberlin DW, Barnett ED, Lynfield R, et al, eds. Red Book: 2021-2024 report of the committee on infectious diseases. 32 nd ed. Elk Grove Village, IL: American Academy of Pediatrics; 2021 [internet publication].
https://publications.aap.org/redbook/book/347/chapter-abstract/5755005/Pinworm-Infection-Enterobius-vermicularis
[10]Naalla R, Sankalp, Shetty P, et al. Worm in vermiform appendix: a surgeon's perspective. BMJ Case Rep. 2014 Jun 27;2014:bcr2014205411.
https://casereports.bmj.com/content/2014/bcr-2014-205411.long