Clinicopathological Assesment in Patients with Enterobius vermicularis Infection

Abstract

Objective: Enterobius vermicularis is a common gastrointestinal parasite. Acute appendicitis is one of the most common clinical conditions requiring surgical intervention. The coexistence of enterobiasis and acute appendicitis has attracted the attention of researchers for a long time. In this article, it is aimed to present the characteristics of enterobiasis cases detected in appendectomy specimens in a tertiary healthcare institution. In addition, it is aimed to reveal the differences by comparing the cases diagnosed with acute appendicitis without enterobiasis.

Methods: All cases operated for acute appendicitis between January 1, 2008 and December 31, 2021 were retrospectively evaluated through the hospital registry system. The cases with histopathologically determined E. vermicularis were reviewed and a study group was formed. The control group consisted of patients diagnosed with acute appendicitis for reasons other than enterobiasis, matched with the study group in terms of age and gender. Complete blood count, C-reactive protein (CRP) ultrasonography evaluations were compared between the two groups.

Results: During the study period, 3.650 appendectomy materials were examined; E. vermicularis was detected in 1.32% (n=48) cases, and acute appendicitis was present in 33.33% (n=16) of the cases. Lymphoid hyperplasia was the most common histopathological change in the study group (n=25; 52.08%). When compared to the control group, leukocyte, neutrophil, CRP, ultrasonographic appendix diameter values were found to be significantly higher in the control group, and the percentage of eosinophils in the study group (p<0.0001; p<0.0001; p<0.0001; p<0.0001; p=0.001; respectively).

Conclusion: Enterobiasis is a common parasite especially in children. Rarely, it can be seen in patients with acute appendicitis. Histopathological evaluation is necessary to ensure a safe surgical procedure and to complete the treatment with anthelmintic drugs. Enterobiasis should be kept in mind in cases when the acute phase response is lower than expected.