Acute appendicitis by Enterobius vermicularis, an unusual etiology in children.

A 7-year-old boy went to emergency department with severe abdominal pain of 20 hours, located in the right iliac fossa. Fever. Alimentary vomit. Normal bowel movements. On examination, the child had general status affectation. Abdominal palpation aimed to voluntary defense in FID. Blumberg and psoas signs were positive. Laboratory tests showed leukocytosis with neutrophilia and eosinophilia. Ultrasound visualized retrocaecal appendix of 6 mm. Urgent laparotomy appendectomy was performed, appreciating macroscopic inflammation of the appendix, without free liquid. Normal ileum. Histopathological examination confirmed the diagnosis of appendicitis; cells of acute inflammation were invading the wall (Fig. 1A) and pinworms occluding the lumen (Fig. 1B). Given these findings, we contacted the family to start treatment with mebendazole.