ECTOPIC ENTEROBIUS VERMICULARIS INFESTATION; AN EXTREMELY RARE CAUSE OF MESENTERIC LYMPHADENOPATHY MIMICKING TUBERCULOUS LYMPHADENITIS
Abstract
Enterobius vermicularis (EV) is a pinworm which commonly resides in the lumen of the intestinal tract and lays eggs on the perianal skin. However, rarely the worm can infest various other sites in the body and cases with infestation of such ectopic sites have been reported in literature. Rare cases of mesenteric lymph node involvement have also been reported. We report a case in a young male who presented with signs and symptoms of acute appendicitis. During surgery, enlarged mesenteric lymph nodes were identified. Histological examination revealed adult worm in the appendiceal lumen. Histological examination of mesenteric lymph node revealed degenerated worm surrounded by caseating chronic granulomatous inflammation. We conclude that EV infestation should be considered in the differential diagnosis of enlarged mesenteric lymph node with chronic granulomatous inflammation, especially in young patients and when accompanying bowel tissue also reveal the helminth. Keywords: Enterobius vermicularis; Mesenteric Lymphadenopathy; Acute Appendicitis; EctopicReferences
Bethony J, Brooker S, Albonico M, Geiger SM, Loukas A, Diemert D, et al. Soil-transmitted helminth infections: ascariasis, trichuriasis, and hookworm. Lancet 2006;367(9521):1521–32.
Rizvi G, Rawat V, Pandey HS, Kumar M. Acute abdomen: An uncommon presentation of a common intestinal nematode. Trop Parasitol 2015;5(2):123–6.
Cook GC. Enterobius vermicularis infection. Gut 1994;35(9):1159–62.
Young C, Tataryn I, Kowalewska-Grochowska KT, Balachandra B. Enterobius vermicularis infection of the fallopian tube in an infertile female. Pathol Res Pract 2010;206(6):405–7.
Craggs B, De Waele E, De Vogelaere K, Wybo I, Laubach M, Hoorens A, et al. Enterobius vermicularis infection with tuboovarian abscess and peritonitis occurring during pregnancy. Surg Infect (Larchmt) 2009;10(6):545–7.
Raju K, Verappa S, Venkataramappa SM. Enterobius vermicularis infestation masquerading as cervical carcinoma: A cytological diagnosis. J Nat Sci Biol Med 2015;6(2):476–9.
Kılıç S, Ekinci S, Orhan D, Senocak ME. Enterobius granuloma: an unusual cause of omental mass in an 11-year-old girl. Turk J Pediatr 2014;56(2):189–91.
Arkoulis N, Zerbinis H, Simatos G, Nisiotis A. Enterobius vermicularis (pinworm) infection of the liver mimicking malignancy: Presentation of a new case and review of current literature. Int J Surg Case Rep 2012;3(1):6–9.
Pampiglione S, Rivasi F. Enterobiasis in ectopic locations mimicking tumor-like lesions. Int J Microbiol 2009;2009:642481.
Pampiglione S, Rivasi F. The presence of pinworms (Enterobius sp.) in the mesenteric lymph nodes, liver and lungs of a chimpanzee, Pan troglodytes. J Helminthol 1990;64(1):29–34.
Ismail KA, Leboudy NA, Radwan NA, Wagdey F. Ectopic enterobius vermicularis in mesenteric lymph node in a child presenting with intestinal obstruction. Rawal Med J 2012;37(1):54–5.
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