Paediatrics - Queensland Health - Queensland Government

Gastrointestinal problems
Intestinal worms
Recommend
Use only pyrantel (Combantrin®) in children under 6 months and in pregnant women
[7]
Perform de-worming in three situations:
-- as part of a community eradication program
-- symptomatic children
-- on the basis of faeces specimen result, sent as part of investigation for anaemia
or weight loss / failure to thrive
Related topics
Anaemia - child Failure to thrive
1. May present with
• Perianal / perineal itch - pinworm (thread worm), small threadlike worm may be
seen (doesn’t cause diarrhoea or failure to thrive)
• Anaemia - hookworm
• Acute diarrhoea - strongyloides
• Failure to thrive - strongyloides can contribute
2. Immediate management Not applicable
3. Clinical assessment
• Obtain a complete patient history:
-- -past episodes
-- -previous weights
-- -length of time signs and symptoms have been present
-- -do any other members of the family or close contact have signs or symptoms?
-- -is the child on medication?
-- -have they been treated for worms? If so when and with what?
• Perform standard clinical observations +
- - weigh - use naked weight in young children and record against most recent
recorded weight
- - check Hb on haemoglobinometer (HemoCue®)
- - collect a faeces specimen for MC/S and OCP (ova, cysts and parasites). This
will be repeated as part of follow up
• Perform physical examination:
-- inspect the abdomen for signs of mobility
-- palpate the abdomen for tenderness or guarding
-- inspect the perianal / perineal area for signs of irritation (if indicated)
4. Management
• Consult MO if abdominal pain present See Abdominal pain
Primary Clinical Care Manual 2011 Controlled copy V 1.0 613