Pinworms (Enterobius vermicularis) may migrate from the anus to the vagina in children and cause intense pruritus that is often most intense during the night, when gravid female worms pass out from the intestinal tract to lay eggs on the perineal skin. Cellophane tape can be used to obtain material for a slide, which can be examined microscopically for the presence of ova, which are large and double walled in appearance. The child and all family members need treatment with an antiparasitic agent, either mebendazole [Vermox (Janssen Pharmaceutica, Inc.)], a single oral dose of 100 mg chewed well, or pyrantel pamoate [Antiminth (Pfizer, Inc.)], a single oral dose of 11 mg/kg (maximum 1 g). Repeat treatment 2 weeks later should be administered, since mature worms seem more vulnerable to treatment than do young worms.14
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