Two female<unk> s next to a ruler. The markings are one millimetre apart. One-third of individuals with<unk>  are totally asymptomatic. The main symptoms are itching in and around the anus and perineum. The itching occurs mainly during the night, and is caused by the female<unk> s migrating to lay eggs around the anus. Both the migrating females and the clumps of eggs are irritating, but the mechanisms causing the intense pruritus have not been explained. The intensity of the itching varies, and it can be described as tickling, crawling sensations, or even acute pain. The itching leads to continuously scratching the area around the anus, which can further result in tearing of the skin and complications such as secondary bacterial infections, including bacterial skin inflammation, and hair follicle inflammation. General symptoms are trouble sleeping, and restlessness. A considerable proportion of children suffer from loss of appetite, weight loss, irritability, emotional instability, and bed wetting.<unk> s cannot damage the skin, and they do not normally migrate through tissues. However, they may move onto the vulva and into the vagina, from there moving to the external orifice of the uterus, and onwards to the uterine cavity, fallopian tubes, ovaries, and peritoneal cavity. This can cause inflammation of the vulva and vagina. This causes vaginal discharge and itchiness of the vulva. The<unk> s can also enter the urethra, and presumably, they carry intestinal bacteria with them. According to Gutierrez (2000), a statistically significant correlation between<unk>  and urinary tract infections has been shown; however, Burkhart & Burkhart (2005) maintain that the incidence of<unk> s as a cause of urinary tract infections remains unknown. One report indicated that 36% of young girls with a urinary tract infection also had<unk> s. Painful urination has been associated with<unk> . The relationship between<unk>  infestation and appendicitis has been researched, but there is a lack of clear consensus on the matter: While Gutiérrez maintains that there exists a consensus that<unk> s do not produce the inflammatory reaction, Cook (1994) states that it is controversial whether<unk> s are causatively related to acute appendicitis, and Burkhart & Burkhart (2004) state that<unk>  causes symptoms of appendicitis to surface.
Pinworm infection
Hookworm infection
Tick infestation
Soil-transmitted helminthiasis
Intestinal parasite infection
Arthropod bites and stings
Myiasis
Dental plaque