Appendiceal Enterobiasis Mimicking Acute Appendicitis: A Case Report

Abstract

Background: Enterobius vermicularis (pinworm) is the most common intestinal helminth, particularly prevalent among children. Although often asymptomatic, it may rarely involve the appendix, either as an incidental finding or as a potential cause of appendiceal inflammation. We present the case of a 25-year-old male who presented with acute right iliac fossa pain, nausea, and localized tenderness. Laboratory investigations revealed leukocytosis. A provisional diagnosis of acute appendicitis was made, and the patient underwent appendectomy. Gross examination showed a mildly inflamed appendix. Histopathology revealed the presence of Enterobius vermicularis within the appendiceal lumen, associated with mucosal inflammation.

Discussion: Appendiceal enterobiasis may clinically mimic acute appendicitis, but the parasite is often identified only upon histopathological examination. The pathogenic role of E. vermicularis in appendicitis is debated, with some authors suggesting it as an incidental finding, while others implicate it as a cause of luminal obstruction and irritation. Detection of the parasite is clinically relevant as it necessitates anti-helminthic treatment to prevent recurrence and community spread.

Conclusion: This case emphasizes the importance of routine histopathological evaluation of appendectomy specimens, as rare etiologies such as Enterobius vermicularis may mimic acute appendicitis and alter postoperative management.