Role of oxyuriasis in maintenance of urinary tract infection among female children

With the fact that oxyuriasis is frequent in early childhood and that renal scarring due to urinary tract infection almost always occurs before puberty, this study investigated 451 female children [4-9 years] with urinary tract infection to assess the role of oxyuriasis in inducing and maintaining UTI among them. Oxyuris infection was detected among 242 girls by perianal adhesive tape technique. Specific antioxyuris and antimicrobial therapy was applied empirically as a first line treatment, however 42 girls [9.3%] showed recurrence of UTI, 21 of them were oxyuris re-infected. The recurrence of UTI was represented by 18 relapses detected within 7 days and 24 reinfections detected after two weeks post treatment. After culture isolation and sensitivity testing, second line specific antimicrobial therapy was applied togehter with antioxyuris therapy. After second line therapy, oxyuris infection was detected in 15 cases out of 19 reinfections [78.9%] and in 4 out of 13 relapses [30.7%], these 32 girls were subjected to intravenous urography [IVU] to detect renal scarring or anatomical abnormalities of the urinary tract, voiding cystourethrogram [VCUG] to detect vesicoureteral reflux [VUR] and to serum IgA assay. The study emphasized the significant role of vesicoureteral reflux in developing renal scarring. However the striking finding was that persistent oxyuriasis among IgA deficient girls in the absence of reflux was as significant as the reflux in developing UTI attributed renal scarring. So the study considered these young girls with combined persistent oxyuriasis and IgA deficiency being under high risk of developing UTI, renal scarring and later in life end stage renal failure. The oxyuris induced perianal pruritis should alert the parents for early detection and treatment of UTI and oxyuriasis especially in view of the high prevalence of asymptomatic IgA deficiency [1:500] together with the nonspecificity of the symptoms of UTI in childhood