Perianal Abscess Due to Eneterobius Vermicularis - International ...

International Journal of Pathology; 2006; 4(1):
Short Communication
Perianal Abscess Due to Eneterobius Vermicularis
Prof Noor Khan Lakhnana, Ambreen Moatasim & Prof Anwar Ul Haque
Department of Pathology, Pakistan Institute of Medical Sciences, Islamabad.
Figure 1: Section showing Skin and
Underlying Intense Eosinophilic
Infiltrate. H&E (X100)
Figure 2: Sections showing Ova
within Gut of Parasite. H&E (X 200)
A 6 year old child presented with
the complaints of perianal itching and
painful defecation for the past 6 months.
On examination a perianal abscess
was noted, that was
drained and the abscess
along with its
margins were sent
for histopathological
examination. On
microscopy, sections
revealed fragments of
skin and underlying
tissue showing intense
eosinophilic infiltrate.
Fragments of worm
along with its eggs
were also identified
deeply embedded and
Figure 3: Sections showing High
Power of Ova. H&E (X 400)
surrounded by tissue reaction. The case was most likely of
Enterobius vermicularis infestation that has penetrated the skin into
the underlying tissue and elicited an intense eosinophilic tissue
reaction leading to the formation of perianal abscess.
Subcutaneous swelling due to Enterobious vermicularis
infection is rare 1 though, Enterobius is known to produce perianal
and ischioanal abscesses 2 . Their presence in perianal subcutaneous
tissue is unusual and a clinical curiosity. Tissue reaction is usually
granulomatous with neutrophils and eosinophils. Lack of familiarity
with the morphology of parasites or its eggs, degeneration, and
inadequate sampling may make the diagnosis difficult. 1
The literature reports 13 cases of enterobiasis presenting as
perianal abscess or granuloma. 3 As the diagnosis of this entity may
create problem especially if representative area is not sampled, we
suggest routine parasite screening for all children presenting with
perianal abscesses. The cytological examination of the pus is also
helpful in the diagnosis 2 and can yield the same diagnostic accuracy
as histopathology provided one is suspicious of the presence of this
entity (enterobiasis) in perianal region.
The purpose of presenting this case is that one should be
aware of parasitic infections at unusual sites.
1

International Journal of Pathology; 2006; 4(1):
References
1. Kumar N, Sharma P, Sachdeva R, Jain S. Perineal nodule due to
enterobiasis: An aspiration cytologic diagnosis. Diagn Cytopathol 2003;
28: 58-60.
2. Das DK, Pathan SK, Hira PR, Madda JP, Hasaniah WF, Juma TH.
Pelvic abscess from enterobius vermicularis. Report of a case with
cytologic detection of eggs and worms. Acta Cytol 2001; 45(3):425-9.
3. Avolio L, Avoltini V, Ceffa F, Bragheri R. Perianal granuloma caused by
Enterobius vermicularis: report of a new observation and review of the
literature. J Pediatr 1998; 132(6):1055-6.
2