Pinworm vaginitis

　　Pinworm disease is an infectious disease caused by the寄生 in the human body. The pinworms burrow into the vagina, causing pinworm vaginitis. The pinworms寄生 in the large intestine, and the female pinworms climb out of the anus within 2 hours after the host falls asleep at night due to the appropriate temperature (34-36℃) and humidity (90%-100%), sufficient oxygen, so they lay a large number of eggs around the anus, perineum, and vaginal folds. The female worms can enter all parts of the reproductive tract, such as the vagina, cervix, uterus, and fallopian tubes. Mechanical and chemical stimulation, as well as the contamination of intestinal bacteria carried by the worms, can cause local allergic reactions and inflammatory infiltration.

　　Complications include: vulvitis, salpingitis, and appendicitis.

　　VulvitisIt is an inflammation of the vulva caused by pathogens or various adverse stimuli, which can exist independently, and more often occurs concurrently with vaginitis, urinary system diseases, anal and rectal diseases, or systemic diseases, or as one of the manifestations in the process of some vulvar diseases.

　　SalpingitisIt is the main site of onset of pelvic inflammatory diseases, mostly occurring in women who are sexually active and have menstrual periods, and is rare before menarche, after menopause, or in unmarried individuals.

　　AppendicitisIt refers to the inflammatory changes of the appendix due to various factors, a common disease in abdominal surgery.

　　Common symptoms include: abdominal pain, diarrhea, bloating, bruxism, purulent discharge, dermatitis, itching, insomnia, eczema, and anorexia.
　　1. Severe itching around the anus and vulva, or accompanied by a burning sensation, worse at night, with an increase in leukorrhea, which may present as yellowish white purulent discharge.

　　2. There may be symptoms such as mild anorexia, bloating, abdominal pain, and diarrhea.

　　3. There may be symptoms such as restlessness, insomnia, night terrors, and nocturnal bruxism.

　　4. The local area may develop dermatitis due to repeated scratching and itching, with redness of the vulvar skin, scratches, eczema, and slight swelling of the vaginal orifice.

　　Eggs can survive outside the body for a long time. Scratching with fingers or eggs on the bedsheet can easily lead to reinfection due to inattention. Boiling, 5% phenol (carbolic acid), and 10% Lysol can kill the eggs.

　　Prognosis: No adverse prognosis after treatment.

　　Health care:

　　1, Take medication as prescribed by the doctor.

　　2, Wash hands thoroughly with soap before meals and after using the toilet.

　　3, Keep nails short, flat, and clean.

　　4, Take a shower and change underwear and bed linens daily.

　　5, Use hot water to wash tableware.

　　6, Clean all toys.

　　7, Thoroughly clean the toilet.

　　8, Maintain normal diet.

　　9, Re-examine after 2 weeks to ensure the elimination of all parasites.

　　Laboratory examination:

　　1. Pinworms generally do not lay eggs in the human intestinal tract, so the positive rate of fecal pinworm detection is less than 5%.

　　2. Anal perianal worm detection method: After 1-2 hours of sleep, thread-like white worms 3-12mm can be observed around the vaginal opening and perianal area.

　　3. Anal perianal ovum detection method: Scrape, wipe, or stick dirt on the anal perianal folds, and examine it under a microscope. Common methods include transparent tape anal swab method and cotton swab method. It is necessary to check once before defecation or bathing in the morning, with a detection rate of 50%. Three times of detection can reach a detection rate of more than 90%.

　　Other auxiliary examinations:

　　Examine the perineum with the middle and index fingers to gently separate the labia majora, and carefully observe the perineum, urethra, and anterior fornix, etc.

　　Vaginal speculum examination: The best examination instrument is the Kelly air bladder scope, which can also be used as a vaginal speculum with a bronchoscope or rhinoscope. Larger girls can use a special small vaginal duckbill instrument. Through the above speculum, one can clearly see the cervix and the condition of the vaginal epithelium and secretions. At the same time, use a small cotton swab to take vaginal secretions for smears. Gram staining can also be used to take secretions for culture, and drug sensitivity tests can be performed to determine the pathogenic bacteria.

　　Digital rectal and abdominal examination: Use the left middle and index fingers to separate both labia majora, insert the right index finger (or little finger if it is difficult to insert the index finger in smaller children) into the child's anus and abdomen, and the other hand cooperate to touch the vagina for foreign bodies, uterine size, and pelvic condition. Rectal examination can also assist in obtaining vaginal secretions. The method is to press the finger of the rectum forward to compress the posterior wall of the vagina, and the other hand holds a disinfected glass tube to squeeze the rectum while aspirating the vaginal secretions.

　　Appropriate diet for pinworm vaginitis patients:

　　Eat more vegetables and nutritious, easily digestible foods to maintain normal digestive function and smooth bowel movements.

　　Food taboos for pinworm vaginitis patients:

　　Avoid spicy, dry, greasy, and unclean foods. Wash unripe fruits and vegetables, and blanch them with boiling water before eating.

　　Pinworm vaginitis food therapy formula:

　　(1) Chinese Hazel nuts: Roast the meat of the Chinese Hazel nuts until they are cooked but not burned, and set aside. For children over 5 years old, take 2 seeds per year per dose, chew them finely, take 3 times a day, for a week. For children under 5 years old, it is better to take the powder of the hazelnut. That is, roast the hazelnut, grind it into powder. Take 1 gram per year per dose, take with warm water, take 3 times a day, for a week.

　　(2) Sunflower seeds: Clean raw sunflower seeds, take twice a day, 30-60 grams each time, for 7 consecutive days. After a 7-day break, you can eat for another 7 days.

　　I. Drug treatment

　　1. Oral therapy

　　(1) Mebendazole (Mebendazole, Anleishi, Mebendazole): Children take 4-6mg/kg at a time. Adults take 200mg at a time; or 100mg twice a day, for 3 consecutive days.

　　(2) Albendazole (Prothionamide, Entamoeba, Albendazole): Children take 100-200mg at a time. Adults take 400mg at a time; or 100mg once a day, for 7 consecutive days. The WHO recommends that all individuals over 2 years of age can take 400mg at a time.

　　(3) Thiabendazole (diphenylhydantoin thiabendazole): 10 mg/kg, taken at bedtime every day for 3 consecutive days.

　　(4) Piperazine (citric acid piperazine, mebendazole, Piperazine): 50 mg/kg, once a day, for 7 to 10 days consecutively.

　　(5) Pyrvinium embonate (Entobex, pyrvinium embonate): 5 mg/kg, taken at once. Some children may experience nausea, vomiting, abdominal pain, and diarrhea after taking it.

　　(6) Albendazole-combined (Saitse): Each tablet contains 67 mg of albendazole and 83.3 mg of thiabendazole. For children over 2 years old, take 1.5 tablets at a time, with a cure rate of 100%.

　　(7) Diethylstilbestrol: 0.1 mg diethylstilbestrol, once a day, then twice a week after two weeks, and can be used continuously for 4 to 6 weeks. Prolonged use may cause secondary sexual characteristics to develop. Choose one of the above drugs, and repeat the medication once every 2 to 4 weeks. It is contraindicated in pregnant women in the early stages of pregnancy and children under 2 years of age.

　　2. Topical Therapy

　　Permethrin cream (containing 3% Cynanchum stauntonii extract, 0.2% methylene blue), 10% zinc oxide cream, 2% mercuric chloride (white mercury) cream, 1% menthol cream, 10% sulfur cream, etc.

　　Topical estrogen cream can promote the regression of inflammation. Apply a cream containing 0.1 mg diethylstilbestrol to the deep part of the vagina with a small cotton swab once a day for a total of 2 weeks. After that, apply it once every 3 to 4 days for a total of 4 to 6 weeks of treatment.

　　Vulvar bath can be taken with potassium permanganate solution at a concentration of 1:10000.

　　The adhesion of the labia minora can be gently inserted and separated using a small curved forceps along the upper or lower small hole, and this separation surgery is easy to perform and does not require anesthesia.

　　2. Lavage Therapy

　　Vaginal lavage can be performed using a 0.5% to 1% lactic acid solution through a rubber catheter inserted into the vagina, and sulfonamides or antibiotic emulsions can be injected through the catheter. The treatment course is once a day for 5 to 7 days.

　　For severe infections, enema can be used with drugs such as Melia toosendan, raw stem of Cynanchum, vinegar, 10% hypertonic saline, and 1% to 5% soap water, with each dose of 100 to 400 ml.

　　3. Prognosis

　　After thorough treatment, if there are no clinical symptoms or signs within one month, and no worm eggs are found in the stool examination, it is considered cured.