Management of Enterobiasis (Enterobius vermicularis)

First‑Line Pharmacologic Therapy

• The United Kingdom guidelines (2025) and the American College of Physicians recommend a single oral dose of albendazole 400 mg or mebendazole 100 mg, each repeated after 2 weeks to eradicate newly hatched worms and prevent reinfection【1】【2】.
• Both agents act as adulticides and ovicidas, providing comprehensive parasite clearance【1】【2】.

Diagnostic Approach

• The preferred diagnostic method is the perianal tape (cellophane tape) test, performed in the early morning before bathing or defecation【1】.

Clinical Presentation

• Nocturnal anal pruritus is the most frequent symptom in infected individuals【1】【2】.
• In females, the parasite may colonize the genital tract, presenting with vaginal discharge【1】【2】.
• Additional possible manifestations include weight loss, irritability, diarrhea, and abdominal pain【1】【2】, and occasional eosinophilic colitis【1】【2】.

Transmission and Reinfection Risk

• Transmission occurs via the fecal‑oral route, autoinfection, and contact with contaminated surfaces【2】.
• Reinfection is common even when effective medication is used, underscoring the need for household-wide treatment and hygiene measures【2】.

Safety Monitoring

• For the standard regimen of a single dose repeated after 2 weeks, routine hepatic or hematologic monitoring is not required【2】.

Treatment for Pinworm Infection

Diagnosis

• The "sellotape test" (cellophane tape test) is the preferred diagnostic method for pinworm infection, performed by placing adhesive tape on the perianal skin in the morning before bathing or defecation to collect eggs 3, 4
• Nocturnal perianal itching is the most common symptom of pinworm infection 5, 4
• Other symptoms may include weight loss, irritability, diarrhea, abdominal pain, and occasionally colitis with eosinophilia 3, 4

Medication Options

• The American College of Physicians recommends first-line treatment options, including albendazole 400 mg as a single oral dose 3, 6, 5
• Mebendazole 100 mg as a single oral dose is also a first-line treatment option 3, 6, 5
• Both medications should be repeated after 2 weeks to kill newly hatched worms and prevent reinfection 5

Special Considerations

• Eosinophilia may be present in some cases, particularly with heavy infections 3, 4
• In females, pinworms may colonize the genital tract, causing vaginal discharge 3, 4