{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,25]],"date-time":"2026-01-25T02:40:44Z","timestamp":1769308844328,"version":"3.49.0"},"reference-count":13,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2017,8,3]]},"abstract":"<jats:p>Acute appendicitis is the most common surgical emergency worldwide. However, it can still present a challenging diagnosis especially in the young, elderly and those individuals of reproductive age, thus encompassing a wide spectrum of varied clinical presentations. Parasitic infections of the appendix are a rare cause of acute appendicitis. However, they must be considered in children presenting with abdominal pain. We report a case of <jats:italic>Enterobius vermicularis<\/jats:italic> infestation mimicking the features of acute appendicitis in a 10-year-old girl. This case is a cautionary reminder of the importance of considering <jats:italic>E. vermicularis<\/jats:italic> infestation in children presenting with abdominal pain, but who do not have a significantly raised white cell count or high Alvarado scores. A history of anal pruritus is the most characteristic symptom, but the parasites can cause severe abdominal pain mimicking appendicitis. Prompt recognition and a high clinical index of suspicion are required to prevent an unnecessary appendicectomy. Caution is advised when performing a laparoscopic appendectomy, as in our case, to prevent contamination of the peritoneum. This infestation is easily treatable with mebendazole.<\/jats:p>","DOI":"10.1136\/bcr-2017-220473","type":"journal-article","created":{"date-parts":[[2017,10,7]],"date-time":"2017-10-07T02:25:13Z","timestamp":1507343113000},"page":"bcr-2017-220473","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":20,"title":["<i>Enterobius vermicularis<\/i> (pinworm) infestation in a child presenting with symptoms of acute appendicitis: a wriggly tale!"],"prefix":"10.1136","volume":"2017","author":[{"given":"Louise","family":"Dunphy","sequence":"first","affiliation":[{"name":"Department of Surgery, Milton Keynes University Hospital, Milton Keynes, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zoe","family":"Clark","sequence":"additional","affiliation":[{"name":"Deparment of Paediatrics, Milton Keynes University Hospital, Milton Keynes, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mazhar H","family":"Raja","sequence":"additional","affiliation":[{"name":"Department of Surgery, Milton Keynes University Hospital, Milton Keynes, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2017,10,6]]},"reference":[{"key":"2025082803435232000_2017.oct06_1.bcr-2017-220473.1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.35.9.1159"},{"key":"2025082803435232000_2017.oct06_1.bcr-2017-220473.2","unstructured":"Centres for Disease Control and Prevention. Parasites \u2013 Enterobiasis. 2001. http:\/\/www.cdc.gov\/parasites\/pinworm\/epi.html"},{"key":"2025082803435232000_2017.oct06_1.bcr-2017-220473.3","first-page":"475","article-title":"Pathology of oxyuriasis: with special reference to granulomas due to the presence of Oxyuris vermicularis [Enterobius vermicularis] and its ova in the soft tissues","volume":"50","author":"Symmers","year":"1950","journal-title":"Arch Path"},{"key":"2025082803435232000_2017.oct06_1.bcr-2017-220473.4","doi-asserted-by":"crossref","first-page":"454","DOI":"10.1016\/0002-9610(68)90241-9","article-title":"Pinworm infestation of the appendix","volume":"116","author":"Tolstedt","year":"1968","journal-title":"Am J Surg"},{"key":"2025082803435232000_2017.oct06_1.bcr-2017-220473.5","doi-asserted-by":"publisher","DOI":"10.3109\/00365529109025051"},{"key":"2025082803435232000_2017.oct06_1.bcr-2017-220473.6","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1002\/path.1700210206","article-title":"On the pathology of worm infection of the vermiform appendix","volume":"21","author":"Matsuoka","year":"1918","journal-title":"J Pathol Bacteriol"},{"key":"2025082803435232000_2017.oct06_1.bcr-2017-220473.7","first-page":"185","article-title":"R61e des helminthes dans l\u2019appendicite","volume":"15","author":"Metchnikoff","year":"1901","journal-title":"Jour d Praticiens"},{"key":"2025082803435232000_2017.oct06_1.bcr-2017-220473.8","first-page":"1504","article-title":"Oxyuren besondersdie\u00a0direkt oder indirekt schuld an der appendicitis","volume":"51","author":"Aschoff","year":"1914","journal-title":"Berl\u00a0klin Wochenschr"},{"key":"2025082803435232000_2017.oct06_1.bcr-2017-220473.9","first-page":"434","article-title":"Ueber die pathologische Bedeutung von Helminthen in der Appendix","volume":"13","author":"Hueck","year":"1913","journal-title":"Frankfurt Ztschr F Path"},{"key":"2025082803435232000_2017.oct06_1.bcr-2017-220473.10","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1007\/s00383-004-1151-5","article-title":"Clinical manifestations of appendiceal pinworms in children: an institutional experience and a review of the literature","volume":"20","author":"Arca","year":"2004","journal-title":"Pediatr Surg Int"},{"key":"2025082803435232000_2017.oct06_1.bcr-2017-220473.11","doi-asserted-by":"crossref","unstructured":"Chaudhary R , Shukla A . Pin worm causing acute appendicitis: case report. 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