Urinary ascariasis in a man with hematuria

¹Department of Surgery, University of Oklahoma Health Sciences, Center, Oklahoma City, USA.

|May 3, 2001

Summary

This case report describes a rare instance of a parasitic infection affecting the urogenital tract. A young man presented with painless blood in his urine and expelled a 6-inch worm during urination. The worm was identified as Ascaris lumbricoides, a parasite typically found in the gastrointestinal tract. This is the first reported case in North America where the parasite appeared in the urinary system. The patient had no prior gastrointestinal symptoms, and the worm was expelled naturally without surgery. The case suggests that A. lumbricoides can migrate beyond the alimentary tract, which is extremely rare. The findings emphasize the need for awareness of unusual parasitic presentations in clinical practice.

Area of Science:

Parasitology in clinical medicine
Urology and genitourinary disorders
Infectious disease diagnostics

Background:

Parasitic infections typically manifest in expected anatomical locations. Ascariasis usually affects the gastrointestinal system, particularly the hepatopancreatic ducts. Prior research has shown that A. lumbricoides rarely migrate beyond the alimentary tract. No prior work had resolved cases where the parasite appears in the urogenital system. This gap motivated investigation into unusual clinical presentations. The global prevalence of A. lumbricoides remains high in endemic regions. However, migration to the urinary tract remains poorly documented. This case highlights a rare anatomical deviation from established norms.

Purpose Of The Study:

The aim of this case report is to document an unusual clinical presentation of A. lumbricoides. The patient presented with painless hematuria and a visible worm in the urethra. This observation challenges typical diagnostic expectations for ascariasis. The researchers propose to expand awareness of non-gastrointestinal manifestations. The study also seeks to inform diagnostic approaches in urology. The patient's symptoms did not align with standard gastrointestinal infection patterns. This case may suggest alternative migration pathways for the parasite. The report emphasizes the need for broader clinical recognition of such anomalies.

Main Methods:

The study involved a single patient presenting with hematuria and a visible worm. Diagnostic imaging was used to assess the urogenital tract. The worm was identified as A. lumbricoides through visual inspection and testing. No invasive procedures were performed to confirm the diagnosis. The patient's medical history was reviewed for prior parasitic infections. Clinical documentation included symptom progression and physical findings. The worm was removed naturally during urination, requiring no surgical intervention. The case was documented for its rarity and diagnostic implications.

Main Results:

The patient expelled a 6-inch A. lumbricoides worm during urination. Hematuria was the primary symptom reported by the patient. No prior gastrointestinal symptoms were documented in the patient's history. The worm was identified visually and confirmed through diagnostic testing. No evidence of gastrointestinal involvement was found in imaging scans. The patient's symptoms resolved after worm expulsion. This case represents the first North American report of urogenital ascariasis. The findings suggest that A. lumbricoides can migrate beyond the alimentary tract.

Conclusions:

The authors propose that this case expands the known clinical presentation of ascariasis. The patient's symptoms and worm expulsion suggest a non-gastrointestinal pathway. The study does not confirm a new migration route for A. lumbricoides. The findings may suggest broader diagnostic considerations in urology. The patient's case does not establish a new treatment protocol. The report emphasizes the need for awareness of rare parasitic presentations. The authors suggest that further case reports may clarify this anomaly. The case highlights the importance of considering unusual locations for parasitic infections.

Keywords:

urogenital parasitic infection Ascaris lumbricoides case unusual worm migration clinical urology diagnosis

Frequently Asked Questions

This case is the first reported North American instance of A. lumbricoides in the urogenital tract, highlighting a rare clinical presentation.

The worm was identified visually and confirmed through diagnostic testing after the patient expelled it during urination.

Typically, A. lumbricoides infects the gastrointestinal tract, but this case involved the urogenital tract, which is extremely rare.

Diagnostic imaging and visual inspection were used to confirm the presence of A. lumbricoides in the patient's urethra.

No prior gastrointestinal symptoms were documented in the patient's medical history before the urogenital presentation.

The authors suggest that clinicians should consider non-gastrointestinal presentations when diagnosing A. lumbricoides infections.

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