Differential Diagnosis for Chief Complaint of Worms in Butt
Single Most Likely Diagnosis
- Enterobiasis (Pinworm Infection): This is the most common cause of anal itching and sensation of worms in the buttocks, especially in children. The infection is highly contagious and can be spread through direct contact or contaminated food and water.
Other Likely Diagnoses
- Anal Fissure: A small tear in the lining of the anus can cause itching, burning, and discomfort, which may be mistaken for worms.
- Hemorrhoids: Enlarged veins in the rectum or anus can cause itching, pain, and discomfort, potentially leading to a sensation of worms.
- Pruritus Ani: A condition characterized by intense itching around the anus, which can be caused by various factors, including skin irritation, allergies, or infections.
Do Not Miss Diagnoses
- Invasive Intestinal Parasites (e.g., Hookworm, Roundworm): Although less common, these parasites can cause significant morbidity and mortality if left untreated. It is essential to consider these diagnoses, especially in patients with a history of travel to endemic areas or exposure to contaminated soil or water.
- Rectal Cancer: Although rare, rectal cancer can cause symptoms similar to those of worms in the butt, including itching, pain, and discomfort. A thorough evaluation is necessary to rule out this potentially life-threatening condition.
Rare Diagnoses
- Schistosomiasis: A parasitic infection caused by Schistosoma species, which can cause rectal symptoms, including itching and discomfort.
- Tapeworm Infection: Although rare, tapeworms can infect the intestines and cause symptoms similar to those of worms in the butt.
- Ectoparasites (e.g., Lice, Mites): Infestations with ectoparasites can cause intense itching and discomfort in the anal region, although this is relatively rare.