ENTEROBIUS VERMICULARIS ASSOCIATED WITH APPENDICITIS WITH HISTOPATHOLOGICAL EVIDENCE OF ACUTE INFLAMMATION: A CASE REPORT

Acute appendicitis is a leading cause of surgical emergencies worldwide. While luminal obstruction by fecaliths or lymphoid hyperplasia is common, parasitic infestation—specifically by Enterobius vermicularis—is an infrequent finding. The pathogenic role of E. vermicularis in acute appendicitis remains a subject of debate, as it is often discovered incidentally without histological evidence of true inflammation. We report a case of a 17-year-old male presenting with classic clinical and radiological signs of acute appendicitis. During emergency laparoscopic appendectomy, multiple motile adult E. vermicularis worms were identified at the appendiceal base. Unlike many incidental cases, subsequent histopathological examination confirmed acute transmural inflammation (suppurative appendicitis) in direct association with intraluminal adult parasites and eggs. The patient’s postoperative recovery was successful following the initiation of anthelmintic therapy (Albendazole) and screening of household contacts. This case underscores that E. vermicularis is not always a bystander but can be a direct primary trigger for acute transmural appendicitis. Surgeons and pathologists, particularly when treating pediatric and young adult populations, should maintain clinical suspicion for parasitic etiologies. Recognition is crucial because surgical intervention must be supplemented with medical anthelmintic treatment to prevent recurrence and community transmission.