The neglected role of Enterobius vermicularis genetic variation in pediatric acute appendicitis

Pediatric acute appendicitis is considered to be one of the most prevalent abdominal emergencies worldwide. While the etiology of appendicitis is believed to be secondary obstruction due to parasitic infection, the role of Enterobius vermicularis in acute appendicitis is not widely recognised. This study aimed to establish a correlation between the genetic diversity of Enterobius vermicularis parasites isolated from patients diagnosed with acute appendicitis, and the patients’ clinical symptoms, ultrasonographic and histopathological findings. This study examined the clinical, radiological, and histopathological findings of patients diagnosed with acute appendicitis over the past decade. The clinical, radiological and histopathological findings of these patients were examined restrospectively. A total of 30 appendectomy specimens identified as Enterobius vermicularis by histopathological methods were included in the study and DNA was isolated from these specimens. The cox1 gene region of Enterobius vermicularis was analysed using PCR and Evm1/Evm2 primers. Enterobius vermicularis genetic diversity was determined by DNA sequencing and phylogenetic analysis. Based on different nucleotide sequencing findings, the parasite was divided into two classes; Enterobius vermicularis variant 1 and Enterobius vermicularis. The genetic distance value between the Enterobius vermicularis isolates was found to be 0.068. The clinical, radiological and histopathological findings of patients with acute appendicitis were examined retrospectively and Enterobius vermicularis was identified as the causative agent. The genetic diversity of Enterobius vermicularis is important for the prognosis of acute appendicitis in children.