What is the treatment and duration for rectal itching after exposure to unknown worms from a puppy?

Treatment for Rectal Itching After Exposure to Unknown Worms from Puppy

For rectal itching after exposure to unknown worms from a puppy, albendazole 400 mg or mebendazole 100 mg as a single dose is the recommended treatment. 1

Diagnosis

Before treatment, proper diagnosis is essential to identify the specific parasite:

• The most likely cause of rectal itching after exposure to puppy worms is pinworm (Enterobius vermicularis), which is characterized by intense perianal itching 1
• Perform the "sellotape test" by placing adhesive tape on the perianal skin in the morning and examining for ova under a microscope 1, 2
• Multiple stool specimens should be examined as eggs may be eliminated intermittently 2

Treatment Options

First-line treatment:

• Albendazole 400 mg as a single dose OR
• Mebendazole 100 mg as a single dose 1, 3

Alternative treatments:

• For hookworm (another possible cause): Albendazole 400 mg as a single dose 1
• For tapeworm infections: Praziquantel 10 mg/kg as a single dose 1, 4
• For dwarf tapeworm (Hymenolepis nana): Praziquantel 25 mg/kg as a single dose 1

Prevention of Reinfection

To prevent reinfection and transmission to others:

• Wash hands and fingernails with soap frequently, especially before eating and after using the toilet 3
• Wear tight underwear both day and night and change them daily 3
• Clean bedroom floors by vacuuming or damp mopping for several days after treatment 3
• Wash bed linens and night clothes after treatment (avoid shaking them) 3
• Keep toilet seats clean 3

Special Considerations

• If the patient is not cured three weeks after treatment, a second course of treatment is advised 3
• No special procedures such as fasting or purging are required 3
• Consider screening household members, as parasitic infections can easily spread within households 2, 5
• Children are at higher risk for infection due to their play habits and attraction to pets 5

Monitoring and Follow-up

• Reassess symptoms after 3 weeks to determine if treatment was successful 3
• If symptoms persist, consider:
  • Retreatment with the same medication 3
  • Alternative diagnosis if symptoms continue despite appropriate therapy 1
  • Evaluation for other potential parasitic infections 1

Public Health Implications

• Proper disposal of pet feces is essential to prevent environmental contamination 5
• Regular deworming of pets, especially puppies, is recommended to prevent zoonotic transmission 5, 6
• Education about personal hygiene and minimizing exposure to potentially contaminated environments is crucial 5

Remember that prompt treatment is important not only for symptom relief but also to prevent spread to others in the household 2, 5.