Finding of Enterobius vermicularis on prostate biopsy: a case report

Abstract

Background: The pinworm, Enterobius vermicularis, usually inhabits the human lower gastrointestinal tract, but aberrant sites of infestation have been described. We report on a rare finding of E. vermicularis in the prostate, which is, as far as we could establish, only the fifth reported case in the English literature.

Case presentation: We report a case of a 60-year-old man who presented with lower urinary tract symptoms, macroscopic haematuria, culture-negative pyuria, and a raised prostate-specific antigen (PSA) level. A subsequent core needle biopsy revealed an E. vermicularis worm in the prostate. This is an extremely rare manifestation, as pinworm is very rarely found in the male genital tract. The proposed route of infection in this case was ascending migration via the urethra to the prostate; however, artificial inoculation by the biopsy needle cannot be excluded.

Conclusion: E. vermicularis can very rarely enter the male urogenital tract where it may potentially cause lower urinary tract symptoms, haematuria, and pyuria that is often culture-negative. The diagnosis is usually unsuspected because of its rarity.