Methods (Differential diagnosis, investigations and treatment)
We doubted E. vermicularis and gave her scotch tape for sampling. We asked her parents to take samples from both her vagina and anus. To our surprise, in addition to the eggs, we observed the female adult worm under the microscope (Figure 1 ). We wanted of mother, father and sister of she to take samples by scotch tape tomorrow morning after waking up and before going to the toilet. Numerous of eggs were observed in the samples of all three of them. The size and shape of the eggs identified as E. vermicularis . Interestingly, the mother and older sister had E. vermicularis infection without any symptoms. Therapy was done by Mebendazole (100 mg, as single dose, next two week repeated) for all member of family. Our cases followed for 3 weeks that we found that all family was cured. In the 4-year-old girl symptoms related to severe anxiety and nervousness, as well as severe vaginal inflammation and itching and vulvovaginitis caused by E. vermicularis , were completely improved.