Unusual presentation of Ascaris lumbricoides in the urinary tract: a case report

Ascaris lumbricoides is one of the most well-known helminthic parasites affecting humans. Ascariasis is prevalent in developing countries where inadequate water, sanitation, and hygiene facilitate human-to-human transmission. In this report, we present a case of a 20-year-old male who arrived at the emergency room with severe right flank pain, high-grade fever, and recurrent vomiting. Diagnostic evaluations were conducted, including a complete blood count test, urinalysis, stool analysis, abdominal ultrasound, and CT scan. The final diagnosis was A lumbricoides found in the distal part of the ureter. A ureteroscopy procedure confirmed the diagnosis and extracted the worm, which measured 6 cm in length, had a brown colour, and exhibited a tight elastic consistency. While Ascaris is commonly found in the gastrointestinal tract, its occurrence in the urinary tract is an extremely rare phenomenon. In our case, the most likely explanation is that the Ascaris accessed the distal ureter through retrograde migration, wherein the worm traverses from the bladder into the ureter.