Discussion
Infection caused by E. vermicularis outside of the intestines is
infrequent, with the female genital tract being the primary site of
involvement. Ectopic enterobiasis has been reported in various regions
of the female genital tract, including the uterus, ovary, vagina,
fallopian tubes, and pelvic peritoneum (17). Cytological examinations
have occasionally identified intestinal parasites that are responsible
for vaginal enterobiasis. While enterobiasis is commonly believed to be
asymptomatic or to only cause minor symptoms such as perianal itching,
it is important to note that this parasite has the potential to cause
severe and potentially life-threatening illnesses, and in some cases,
even death (6). Non gastrointestinal manifestations of Enterobiusvermicularis are such as pruritus vulvae, urinary tract
infections, postmenopausal bleeding, epididymitis, pelvic mass,
tubo-ovarian abscess, and generalized peritonitis (6, 11). The invasion
of the endometrial cavity by E. vermicularis can result in the
development of endometritis and salpingitis (9). It is crucial to avoid
mistaking them for other types of parasitic ova, pollen grains, or
tainted plant cells (9, 18). The dimensions of Enterobiusvermicularis eggs are 55 µ in length and 25 µ in width, with the
width being half of the length (9). The presence of these
characteristics aids in differentiating from other possible impurities
that may be present in vaginal specimens, such as fibers, plant matter,
fungi, and so on (19). Studies has shown that E. vermicularis has
the ability to invade the urinary and vaginal tracts in female children,
resulting in the development of vulvovaginitis (20). Our case was a
4-year-old girl who had severe vaginal itching caused by E.
vermicularis and was highly anxious and nervous. The entire family was
also infected with this parasite. enterobiasis is a widely recognized
form of parasitic infection that affects children (21) with a prevalence
about 17.2 % in Iran (22, 23).