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In a 32-year-old woman suffering from severe diarrhoea, eosinophilic infiltration of colonic mucosa and a peripheral eosinophilia, microbiological investigations only revealed large numbers of Enterobius vermicularis (pinworm) in the faeces. Treatment with mebendazole resulted in a rapid resolution of symptoms and disappearance of the eosinophilia, which strongly suggested a causative role of this pinworm in the clinical syndrome of the patient. E. vermicularis is generally regarded as an innocent nematode, which at most causes perianal pruritus due to migration of worms from the colon and expulsion of eggs onto the perianal skin. Although the pinworm maturates and lives in the gut, gastrointestinal symptoms have seldom been reported. E. vermicularis infection should be considered in patients with unexplained eosinophilic enteritis.

Since the introduction of aerosolised pentamidine for prophylaxis against Pneumocystis carinii pneumonia (PCP) in HIV-seropositive persons and patients with AIDS, an increasing number of cases of atypical manifestations of infection with Pneumocystis carinii have been reported in the United States, viz. upper lobe pneumonia, extrapulmonary Pneumocystis carinii infection and spontaneous pneumothorax. An association between these atypical manifestations of Pneumocystis carinii infection and the use of aerosolised pentamidine seems likely. This report is the first description in the Netherlands of an atypical Pneumocystis carinii infection in an AIDS patient while using aerosolised pentamidine for prophylaxis against PCP. Since aerosolised pentamidine for prophylaxis against PCP is increasingly being used in the Netherlands, a rise in incidence of atypical manifestations of Pneumocystis carinii infection can be expected.