Case Study: Microbiology

Microbiology
CASE STUDY
Case
 A 3 year old female presents with nocturnal
perianal itching associated with
restlessness and insomnia. Mother of the
patient also admitted that her daughter
presents with occasional vomiting and
abdominal pain.
 Moreover, her 7 year-old son, who is in the

school, also present the same signs and
symptoms.
WHAT ARE POSSIBLE
DISEASES TO
CONSIDER?
Possible Parasitic
 Diseases
Ascariasis
 Pinworm Infection
 Cryptosporidiosis
Pinworm
Infection
 The pinworm (genus En
terobius), also known
as threadworm or seat
worm, is a common
human intestinal parasite
 The medical condition
associated with pinworm
infestation is known
as enterobiasis, or
sometimes oxyuriasis.
Pinworm Infection
 Morphology:
 The pinworm appears as a white, small and delicate nematode (i.e.,
roundworm).
 The adult female has a sharply pointed posterior end, is 8 to 13
millimeters long, and 0.5 millimeters thick.
 The adult male is considerably smaller, measuring 2 to 5 millimeters
long and 0.2 millimeters thick, and has a curved posterior end.
 The eggs are translucent and have a surface that adheres to
environmental objects.
 The eggs measure 50 to 60 micrometers by 20 to 30 micrometers, and
have a thick shell that is flattened on one side.
 The small size and colorlessness of the eggs make them invisible to
the naked eye, except in barely visible clumps of thousands of eggs.
Eggs may contain a developing embryo or a fully developed pinworm
larva.
 Inside the host, the larvae grow to 140-150 micrometers in length.
Pinworm Infection
 Incubation Period:
 The incubation time from ingestion of

eggs to the first appearance of new
eggs around the anus is 4 to 6 weeks.
Pinworm Infection: LIFE
CYCLE
 The entire lifecycle — from egg to adult — takes place in the
human gastrointestinal tract of a single human host. The lifecycle begins with eggs
being ingested.
 The eggs hatch in the duodenum (i.e., first part of the small intestine).
 The emerging pinworm larvae grow rapidly to a size of 140 to 150 micrometers in
size, and migrate through the small intestine towards the colon.
 During this migration they moult twice and become adults. Females survive for 5 to 13
weeks, and males about 7 weeks.
 The male and female pinworms mate in the ileum(i.e., last part of the small
intestine), where after the male pinworms usually die, and are passed out with stool. The
gravid female pinworms settle in the ileum, caecum (i.e., beginning of the large intestine),
appendix and colon, where they attach themselves to the mucosa and ingest colonic
contents. Almost the entire body of a gravid female becomes filled with eggs.
 The egg-laying process begins approximately five weeks after initial ingestion of pinworm
eggs by the human host. The gravid female pinworms migrate through the colon towards
the rectum at a rate of 12 to 14 centimeters per hour.
 They emerge from the anus, and while moving on the skin near the anus, the female
pinworms deposit eggs either through (1) contracting and expelling the eggs, (2) dying
and then disintegrating, or (3) bodily rupture due to the host scratching the worm. After
depositing the eggs, the female becomes opaque and dies. The reason the female
emerges from the anus is to obtain the oxygen necessary for the maturation of the eggs.
Pinworm Infection: LIFE CYCLE
Pinworm
Infection
 Symptoms:
 Itching of anus
 Irritation of Perennial area
 Abdominal Pain
 bloody bowel movements,
 fevers
 poor appetite
Pinworm
Infection
 Nursing Intervention
 Carry out therapeutic regimens as prescribed or support and

assist parents in carrying out treatment plan to promote skin
healing.
 Provide moist environment (ointment) for optimum healing.
 Administer topical treatments and applications.
 Administer systemic medications, if ordered.
 Prevent secondary infection, since these delay healing.
 Reduce external stimuli that aggravate condition, causing delay
in healing.
 Encourage rest to support body’s natural defenses.
 Administer skin care and general hygiene measures to promote
skin healing.
Pinworm
Infection
 Medical Treatment
 albendazole (Albenza) is the most

Medical Treatment common treatment
for pinworms
 Mebendazole (Vermox)
Pinworm
Infection


Health teaching:
Practice good hygiene. Washing your hands before eating

or preparing meals helps prevent spread of infection.
 Avoid scratching the anal region.
 Avoid biting the fingernails.
 Keep fingernails short and clean.
 Wash all bedding and pajamas regularly.
 Be sure your child changes underwear daily.
 Frequently vacuum the play area.
 Despite these measures, it still may be quite difficult to
avoid reinfecting yourself or spreading pinworms to others.

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Microbiology

 Moreover, her 7 year-old son, who is in the

 The incubation time from ingestion of

 Carry out therapeutic regimens as prescribed or support and

 albendazole (Albenza) is the most

Practice good hygiene. Washing your hands before eating

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