Case Report: Incidentally Discovered Strongyloides stercoralis Infection after Urinary Diversion

Area of Science:

• Parasitology
• Urology
• Infectious Diseases

Background:

• Strongyloidiasis is a human parasitic infection caused by Strongyloides stercoralis.
• Urinary tract involvement is an uncommon manifestation of strongyloidiasis, often associated with hyperinfection syndrome.

Observation:

• A case of incidental Strongyloides urinary tract infection is presented in a patient with a history of urologic surgery involving urinary diversion via ileal loop conduit.
• Pre-operative eosinophilia and parasite detection were noted, alongside evidence of endemic exposure.
• The presence of rhabditiform larvae in urine differentiated this case from hyperinfection, suggesting localized transfer from the bowel.

Findings:

• The patient's urinary tract infection was attributed to the ileal loop conduit, facilitating localized Strongyloides transfer.
• Treatment involved antibiotics for secondary bacterial infections and ivermectin for the parasitic infection.
• Recovery was achieved with the combined therapeutic approach.

Implications:

• This case highlights a novel route of Strongyloides urinary tract infection secondary to urologic reconstruction.
• It underscores the importance of considering parasitic infections in patients with unusual urinary symptoms post-surgery.
• The findings contribute to understanding the varied clinical presentations of strongyloidiasis and its management in specific surgical contexts.