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Melissa, B.S. Biology/Psychology
Category: Health
Satisfied Customers: 1335
Experience:  B.S. Biology/Psychology - University of Georgia
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I have pin-worms in my nose and sinus cavities. Help!

Customer Question

I have parasites (pinworms) in my nose and sinus cavities that I can't get rid of. I have used the intestinal rid medications, sinus care sprays with antiseptic and constantly clean nose with q-tips when I feel them tickling. I probably remove 15-20 a day. Sometimes they are even in my ears. What can I do to get rid of them?
Submitted: 9 years ago.
Category: Health
Expert:  Melissa replied 9 years ago.

Worms in the nasal passages would be extremely rare, but a couple of cases of pin worms enterobius vermicularis have been reported (see;year=2005;volume=57;issue=2;spage=148;epage=150;aulast=Kaniyur). This would not be the only possible cause of parasites in the respiratory tract, however. For example, another type of roundworm, Ascarids, can infect the lungs in humans, and the juvenille worms can crawl into the respiratory tract and out of the nose. There's also a possibility that you're suffering from some kind of mite or other insect (scabies, louse, etc). Parasites such as these are nearly impossible to diagnose without experience in medicine or parasitology. Though what you see and experience coming out of your nasal passages and ears may be very real, the interpretation of what you're seeing and feeling may be more difficult to determine, especially when it comes to self treatment. A microscopic examination and/or smear might be required in this case, as there might be a co-occuring infection accompanying your symptoms, which needs to be treated as well. Treatment will depend on the exact nature of the problem. For example, certain roundworms like pinworms and ascarids can be treated with mebendazole or albendazole oral medications (available OTC in some areas), and steroids, but fungal or bacterial infections would require completely different remedies.

I hope this helps!

Melissa, B.S. Biology/Psychology
Category: Health
Satisfied Customers: 1335
Experience: B.S. Biology/Psychology - University of Georgia
Melissa and other Health Specialists are ready to help you
Customer: replied 9 years ago.

Thanks so much for your research concerning my unusual condition. I tried to get an appointment with an ENT today but couldn't get in until the 19th. They suggested seeing my primary care to see if I could get in sooner. Saw my PCP today and she also seemed to be unconvinced, even though I took her a sample. She didn't examine it under a microscope but did look up info and found the same article about a 11 year old girl.
She did prescribe Mebendazole tablets for myself and family members. If this doesn't work she will refer me to an ENT.
Can this condition actually be so uncommon. I do think that I contacted the pin-worms from my grandson and searched info on the web. It is my understanding that you contact them orally by ingesting eggs or by breathing in the eggs. So why would it be so unusual for them to be in the nasal cavities?
Thanks so much for your reply and I am sorry I didn't receive your info before my appointment so that I could share it with her.

Expert:  Melissa replied 9 years ago.

Hi Customer,

You're correct in saying that the pin-worm eggs can be ingested and inhaled and contracted in this way, but they thrive in the rectal environment and crawl to the anus at night to lay eggs. This is just the environment that they're most adapted to, and is at the perfect temperature, moisture level, and nutrient environment for them to live in. Finding them elsewhere has been documented, as you know, but it's sort of like finding a monkey in a desert... A little odd for this organism. As I mentioned, however, there are other types of worms that could be possibly found in the respiratory passages. The good news is that the oral medications that kill pin-worms are also good at killing other types of parasitic worms, so hopefully, whatever you have will resolve with the Mebendazole you've been given. If not, a specialist needs to examine a sample more closely to identify your sample, look for the presence of eggs, infection, irritation, etc. Understandably, I can imagine how frustrating this might be, having a mysterious and confusing ailment that your doctor seems to have no real answers for at the moment... But each step that you try will bring you a little closer to getting rid of this likely annoying problem.

Let us know how the Mebendazole works, and the results of any future ENT visits. I think you've aroused the curiosity of many of our experts here.

Customer: replied 9 years ago.
I do seem to have some kind of polyp on one side of my nasal cavity and I did read that pinworms are sometimes found in them. This may be the enviorement that they need to survive? Also my PCP said that I had small bumps in my nose where they may be living inside the tissue. I just hope the meds take care of them. Though the info that came with the meds says that it is used for worm infections elsewhere in the body but in these cases should be taken more often and for a longer time? I hope my single treatment works. It can be prescribed for more than twice a day and up to 3 days. That seems like overkill.
The over the counter treatment had very unpleasant side effects, I would think they will be evenmore so with this med.
Expert:  Dr. D. Evans replied 9 years ago.

Firstly, it is impossible for any intestinal worm to survive in the nose or sinuses. The case of pinworm reported in the nose is unverified, and goes against all knowledge of medical science. Intestinal parasites are highly specialised, so much so that a worm that lives in the small intestine wont live in the large intestine. It is absolutely impossible that you are having intestinal worms in your nose or ears.

There are two possibilities:

Myiasis: in some diseases like atrophic rhinitis or cancers of the nose, where there is a lot of dead tissue in the nose, flies may lay their eggs which eventually hatch into larva and crawl about, this is called Myiasis. This occurs in tropical countries like India or Africa, it would be very rare in Florida. In this case, you would have to have a prior chronic and severe nose disease like atrophic rhinitis. Still, you should consult an ENT doctor to rule out such diseases. You can look up here:

The second and far more likely cause is that you are suffering from Delusional Parasitosis. This is a condition when the subject becomes convinced that he is having a parasitic infestation of the body. The symptoms of crawling sensation that you describe are typical. It is very likely that what you feel are parasites are nothing more than crusts in the nose. This is not an uncommon condition. You should consider now the option of a psychiatrist consultation. Psychological diseases are as much diseases as physical diseases. We need to get them treated as matter of factly as we treat a physical disease. The proper specialist for treating a psychological condition is a psychiatrist. You must approach a psychiatrist and discuss your symptoms with him. There are effective ways to cure you of this. You can look up here:

So, my suggestion to you is, to consult an ENT doctor, and if he finds no problem in your nose, to consult a psychiatrist.