Enterobius vermicularis-induced atypical acute appendicitis in a pediatric patient: a case report from Pakistan

The role of Enterobius vermicularis in triggering appendicitis remains controversial as an incidental finding or actual etiology. Its clinical symptoms mimic acute appendicitis characterized by sudden severe abdominal pain with nausea and vomiting. The appendiceal histoarchitecture often depicts reactive lymphoid hyperplasia marking the parasite presence as a questionable etiology. We report the case of an 11-year-old boy presenting with right lower quadrant abdominal pain and perianal itching. Examination revealed positive guarding and tenderness. Biochemical markers were normal. Abdominal ultrasound suggested parasitic infestations in the appendiceal lumen. Open appendectomy revealed an inflamed tissue with lumen obstructed by helminths. Postoperative standard antibiotic cover with albendazole was administered. This case emphasizes E. vermicularis as an etiology of atypical acute appendicitis and highlights the need for early recognition and management of such patients.