IntroductionVulvovaginitis is inflammation of the vulvovaginal mucous membranes (1) that responsible of some of pediatric gynecology consultations (2). Prepubertal girls commonly experience a gynecologic issue, which is often characterized by symptoms such as vulvovaginal itching, discharge, irritation, burning or skin changes. The development of these symptoms is primarily influenced by anatomic, physiological, and behavioral factors specific to this age group (3). Streptococcuspyogenes , Haemophilus influenzae andEnterobius vermicularis emerge as the predominant pathogens, while fungal and viral infections exhibit lower occurrence rates (4). The presence of genital discomfort or a burning sensation during urination is often observed in cases of vulvovaginitis. This condition, which is more prevalent in prepubescent girls, can caused by a deficiency of estrogen and poor local hygiene leading to infection of the vaginal mucosa. Despite the lack of precise data on its prevalence, these predisposing factors are known to contribute to the development of vulvovaginitis (3).In addition, favor factors of development of this disease include local alkaline pH, thin labia minora and reauctioned estrogen stimulus during the prepubertal period results in thinning of the vulvovaginal epithelium. Among prepubertal girls, the most common clinical presentation is nonspecific vulvovaginitis caused by endogenous vaginal flora (5). One of the most agents of vulvovaginitis is a parasite calledEnterobius vermicularis (E. vermicularis ) (4). This worm exhibits the most extensive geographical distribution among helminths (6). Its induced infection is a global phenomenon and is recognized as the most prevalent form of helminth infection (7). This condition is prevalent across all age groups and socioeconomic backgrounds, although it is particularly widespread among children between the ages of five and fourteen (8, 9). It is important to note that parasitic infections even in children may lead to malnutrition and decreased learning abilities (10). Embryonated eggs can be detected on various surfaces such as fingernails, clothing, house dust and other objects. Once these eggs are ingested, they undergo hatching within the stomach, giving rise to larvae.These larvae then make their way to the cecum, where they undergo further development and eventually reach adulthood as pinworms, measuring approximately 1 cm in length. The gravid adult female worms exhibit a nocturnal migration to the perianal region, where they lay a substantial number of eggs, up to 11,000 in total. These eggs become infective within a relatively short period of time, approximately six hours after being deposited. The lifespan of E.vermicularis typically ranges from 11 to 35 days (8). Transmission of the infection takes place via direct transmission from an infected individual through the oral-anal route, or through the dispersal of airborne eggs from contaminated clothing or bed linen. Upon ingestion, the eggs hatch and release larvae within the intestine (11).Adult worms in girls may also infiltrate the vagina to release eggs and consequently leading to the development of vulvovaginitis. In 1980, Vaughan reported one of the first enterobiasis in direct observation of vaginal region (9, 12). Moreover, these worms possess the ability to invade the endometrial cavity, thereby inducing endometritis and salpingitis in affected patients (9). For diagnosis collection of eggs from infected area (anus or vagina) can be achieved through the use of the cellophane swab or scotch tape swab method. stool examination not be a reliable means of detecting eggs (13). Cases have been documented wherein this worm have traversed the entire of the reproductive system and penetrated the peritoneal cavity by means of the fallopian tubes (9). In this paper we presented a 4 years Iranian girl that suffered of vulvovaginitis caused by E. vermicularis . her family infected by this parasitic helminth too.
