Discussion
Infection caused by E. vermicularis outside of the intestines is infrequent, with the female genital tract being the primary site of involvement. Ectopic enterobiasis has been reported in various regions of the female genital tract, including the uterus, ovary, vagina, fallopian tubes, and pelvic peritoneum (17). Cytological examinations have occasionally identified intestinal parasites that are responsible for vaginal enterobiasis. While enterobiasis is commonly believed to be asymptomatic or to only cause minor symptoms such as perianal itching, it is important to note that this parasite has the potential to cause severe and potentially life-threatening illnesses, and in some cases, even death (6). Non gastrointestinal manifestations of Enterobiusvermicularis are such as pruritus vulvae, urinary tract infections, postmenopausal bleeding, epididymitis, pelvic mass, tubo-ovarian abscess, and generalized peritonitis (6, 11). The invasion of the endometrial cavity by E. vermicularis can result in the development of endometritis and salpingitis (9). It is crucial to avoid mistaking them for other types of parasitic ova, pollen grains, or tainted plant cells (9, 18). The dimensions of Enterobiusvermicularis eggs are 55 µ in length and 25 µ in width, with the width being half of the length (9). The presence of these characteristics aids in differentiating from other possible impurities that may be present in vaginal specimens, such as fibers, plant matter, fungi, and so on (19). Studies has shown that E. vermicularis has the ability to invade the urinary and vaginal tracts in female children, resulting in the development of vulvovaginitis (20). Our case was a 4-year-old girl who had severe vaginal itching caused by E. vermicularis and was highly anxious and nervous. The entire family was also infected with this parasite. enterobiasis is a widely recognized form of parasitic infection that affects children (21) with a prevalence about 17.2 % in Iran (22, 23).