Treatment of Intestinal Worms in a 5-Year-Old Girl
For a 5-year-old girl with worms in her feces, albendazole 400 mg as a single oral dose or mebendazole 100 mg twice daily for 3 days is the recommended first-line treatment, depending on the specific type of worm identified. 1
Identification of Worm Type
Before selecting treatment, it's important to identify the type of worm:
- Roundworm (Ascaris lumbricoides): Pink or white adult worms that resemble earthworms, may be passed in stool 1
- Pinworm (Enterobius vermicularis): Small white thread-like worms, often causing perianal itching, especially at night 2
- Hookworm: Microscopic examination of stool required for diagnosis 1
- Whipworm: Microscopic examination of stool required for diagnosis 1
- Tapeworm: Segments may be visible in stool 1, 3
Treatment Options Based on Worm Type
For Roundworm, Hookworm, and Whipworm:
- First-line treatment: Albendazole 400 mg as a single dose OR mebendazole 100 mg twice daily for 3 days 1, 4
- Alternative: Ivermectin 200 μg/kg as a single dose 1
For Pinworm:
- First-line treatment: Mebendazole 100 mg as a single dose, repeated after 2 weeks 4, 5
- Alternative: Pyrantel pamoate (dosage based on weight) 5
For Tapeworm:
- For Taenia saginata: Praziquantel 10 mg/kg as a single dose 3
- For Taenia solium or unknown tapeworm species: Niclosamide 2 g as a single dose 3
- For Hymenolepis nana (dwarf tapeworm): Praziquantel 25 mg/kg as a single dose 1
Administration Guidelines for Children
- For young children who cannot swallow tablets, mebendazole is available as a chewable tablet 4
- Tablets can be crushed and mixed with food if necessary 4
- Treatment should be given regardless of whether the child is symptomatic 1, 5
Prevention of Reinfection
After treatment, implement these measures to prevent reinfection:
- Hand hygiene: Wash hands and fingernails with soap frequently, especially before eating and after using the toilet 1, 4
- Clothing: For pinworm infections, wear tight underwear, change daily 4
- Bedding: Wash bed linens and night clothes after treatment 4
- Environmental cleaning: Clean bedroom floors by vacuuming or damp mopping for several days after treatment 4
- Food safety: Wash all fruits and vegetables thoroughly 4, 6
- Footwear: Wear shoes outdoors, especially in areas with warm soil 4
Family Treatment Considerations
- For pinworm infections, consider treating all household members simultaneously to prevent reinfection 2, 7
- For other worm infections, examine stool samples from family members to determine if treatment is needed 1
Follow-up
- For persistent symptoms, a repeat stool examination should be performed 2-3 weeks after treatment 1
- For pinworm infections, a tape test can be performed in the morning to check for clearance 5
- Consider a second dose of medication 2-3 weeks after initial treatment, particularly for pinworm infections 4, 2