A 5-year-old girl is brought to the physician by her parents due to intense perianal itching, especially during the night. The patient is otherwise healthy and her development has been normal. Physical examination shows perianal excoriation. Cellulose adhesive tape is applied to the perianal area shortly after she wakes in the morning. Microscopic analysis of the tape reveals the presence of eggs that are asymmetrically flattened on one side. Which of the following is the most appropriate treatment for this patient's condition?

Question

A 5-year-old girl is brought to the physician by her parents due to intense perianal itching, especially during the night.  The patient is otherwise healthy and her development has been normal.  Physical examination shows perianal excoriation.  Cellulose adhesive tape is applied to the perianal area shortly after she wakes in the morning.  Microscopic analysis of the tape reveals the presence of eggs that are asymmetrically flattened on one side.  Which of the following is the most appropriate treatment for this patient's condition?

Quizplus · Accepted Answer

11ec160b_3bf8_dfec_9249_8dd3ed7df09a_MD0001_00 Enterobiasis, caused by the pinworm (Enterobius vermicularis), is the most prevalent helminthic infection in the United States and is frequently seen in children. The life cycle occurs in the gastrointestinal tract, and the adult worms typically live in the cecum and appendix. In contrast to other worms that release eggs into the intestine, the female worm migrates to the perianal area at night to deposit eggs. Larvae mature in the eggs within 6 hours, and the infective eggs can either be ingested by the same individual or spread to other humans. Eggs and worms in the perianal area cause an inflammatory reaction, resulting in perianal itching (pruritus ani). Scratching contaminates the hands and furthers transmission. Diagnosis is made by the cellulose tape test (ie, microscopy of adhesive tape applied to the perianal region), which reveals oval eggs flattened on one side. Treatment options include albendazole, mebendazole, and pyrantel pamoate. (Choice B) Diethylcarbamazine is indicated for the treatment of Loa loa (loiasis) and Wuchereria bancrofti (lymphatic filariasis) infections. (Choice C) Ivermectin is used to treat infections caused by Strongyloides stercoralis (strongyloidiasis) and Onchocerca volvulus (onchocerciasis). (Choice D) Nifurtimox is used to treat diseases caused by trypanosomes, including Trypanosoma cruzi (Chagas disease). (Choice E) Infections caused by Schistosoma (schistosomiasis), Clonorchis sinensis (clonorchiasis), and Paragonimus westermani (paragonimiasis) are treated with praziquantel. Educational objective: Enterobius vermicularis infection (enterobiasis) occurs most frequently in children and presents with perianal pruritus. Diagnosis is made by identifying eggs in the perianal region (cellulose tape test). Treatment options include albendazole, mebendazole, and pyrantel pamoate.

A 5-Year-Old Girl Is Brought to the Physician by Her