How OLD is your son?

When you give medical advice on the phone, or over the Internet on WebMD, one of the most important bits of information is the age of the patient.

Many years ago, I responded to a phone message from a worried mother. "I think my son has pinworms", she said. Pinworms are relatively common pediatric infestations, the predominant symptom being a very, very itchy butt. Pinworms live in the lower intestinal tract and have a nasty habit of emerging at night to lay eggs along the anal ring and socialize with other worms. I was once asked by a student, "How do pinworms know it is night?" --- an unanswerable question to this day. Pinworms are harmless, but very socially undesirable.

There are three ways to diagnose pinworms: 1. Send a stool specimen to the lab and have the lab tech dig through the poop and physically look for them. 2. Use a "Scotch Tape" test where a sticky plastic paddle is tapped around the anal ring hoping to find some microscopic eggs. 3. Having the parent physically LOOK for the live pinworms crawling around the anus...a task that must be done at night (when pinworms emerge).

I told the parent that she would have to go into her son's dark bedroom at night while he is sleeping. She would carefully pull down his underwear, spread his butt cheeks, and use a flashlight to search for these tiny, white, thread-like worms around his anus. Our phone call became a period of uncomfortable silence.

"He is 16 years old!"

It is very important to always ask the AGE of your patient before answering phone questions.

Related Links: Contagious Creepy Crawlies, Pinworms: Symptoms

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