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Pinworm infection is caused by the parasite Enterobius vermicularis, a slender white worm with a pointed tail. In humans, they reside in the large intestine and appendix. Female pinworms are 8 to 13 mm long, and males are 2 to 5 mm long. Pinworm infection is primarily seen in children, and parents may be typically affected through their children. Thus, do you have children in your house who has been affected by worm infestation or are being treated? Transmission may also happen via direct contact with contaminated furniture, bedclothes, bedding, towels, toilets, doorknobs, or other objects. The parasite can also be transmitted during sexual contact. Do you have anyone else living with you in your house who may have been diagnosed with pinworm or any other worm infestation? Pinworm infection generally does not produce symptoms; asymptomatic carriers are common. However, there may be symptoms, including itching and pain around the anus, lack of sleep, or an initial sign of loose stools or diarrhea. The complications may include appendicitis, perianal eczema, or a bacterial infection around the rectum due to scratching the itchy area. In girls, pinworm infection can spread to the vagina and cause a vaginal discharge. As per your description, you seem to have anal itching and occasional diarrhea, which might suggest a worm infestation. You also complained of vaginal itch and discharge, listed as a complication. Abdominal bloating is nonspecific and can be caused by multiple reasons, including worm infestation but other causes, such as gastritis, GERD (gastroesophageal reflux disease), and irritable bowel syndrome, among other ailments, due to the side effect of current medications. You mentioned the loss of appetite and weight loss, which again may be caused by worms or other ailments due to the side effects of drugs currently being taken by you. Pinworm is diagnosed by detecting worm eggs and female worms.
The pale-colored female pinworm (about 10 mm) may be seen around the anus with the naked eye. The worm's appearance may be confused with bits of cotton thread. Eggs (30 μm X 50 to 60 μm) are usually not seen without a microscope. A specimen is best obtained by dabbing the stretched, unwashed perianal folds in the early morning with cellophane tape and affixing the specimen onto a slide. A negative test for five consecutive mornings effectively rules out the diagnosis. I hope your doctor has undertaken such tests. The pictures that you attached (attachment removed to protect the patient's identity) may not be those of worms. However, a microbiologist is the best person to confirm the same. The pictures may be those of mucus-like specimens. Also, the stool tests have suggested negative tests. However, this does not mean there may not be worms in the past (which may have spontaneously been expelled) or may not be in the future. Antihelminths or anti-worm medications should be taken to rule out any possible future or current infestation. Kindly do not discontinue the current medications.