Enterobius vermicularis, also known as the pinworm or seatworm, is commonly diagnosed with the scotch tape test and should be treated with mebendazole.
The pinworm is a roundworm (or nematode) that has the largest geographic range of any helminth and commonly presents clinically in children with perianal pruritis and/or poor sleep. Several reports have demonstrated that this parasite may be successfully treated with a prolonged course of antiparasitic agents including mebendazole or albendazole.
Kucik et al. describe the diagnostic gold standard as direct visualization of the adult worm or microscopic detection of eggs via the “cellophane tape test." This test consists of touching clear tape to the perianal area several times, removing it, and examining the tape under direct microscopy for eggs. They report that performing the test during waking hours on three consecutive days increases sensitivity to >90%.
Dennie and Grover show that a weekly course of 100mg of medendazole (and repeat course for recurrent symptoms) is an effective treatment for Enterobius vermicularis in prepubescent girls.
Image A shows a cellophane tape strip with two pinworms attached on a pathology slide. This is a positive test for Enterobius vermicularis.
Illustration A demonstrates the proper method for performing a scotch tape test. Illustration B shows perianal pinworms in an infected individual.
Answer 1: The appropriate treatment for Enterobius vermicularis is an antiparasitic agent such as medendazole or albendazole. It is not appropriate to leave these individuals untreated as more serous gastrointestinal or genitourinary infections can occur, and untreated individuals serve as a reservoir for other unaffected individuals.
Answer 2: Topical cortisone cream may provide symptomatic relief of pruritis in affected individuals, but is not a treatment for the worm.
Answer 3: Ivermectin is an effective treatment for river blindness caused by onchocerciasis, not pinworms.
Answers5: Niclasamides in conjunction with laxatives can be used in the treatment of Cestoda infections (i.e. Tapeworms), but is not a common treatment for pinworms.
Kucik et al. Am Fam Physician. 2004 Mar 1;69(5):1161-1169.
PMID:15023017 (Link to Abstract)
Dennie and Grover. J Paediatr Child Health. 2013 Feb;49(2):138-40. doi: 10.1111/jpc.12085. Epub 2013 Jan 18.
PMID:23331477 (Link to Abstract)