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Ascariasis of the kidney
1Department of Anatomical Pathology, Red Cross War Memorial Children's Hospital, Cape Town, South Africa.
Summary
A rare case of kidney ascariasis (Ascaris lumbricoides infection) in a child is detailed. Mature worms likely entered the urinary tract via the urethra, causing severe kidney damage and infection.
Area of Science:
- Urology
- Infectious Diseases
- Parasitology
Background:
- Ascariasis, caused by the roundworm Ascaris lumbricoides, is a common intestinal nematode infection globally.
- Renal ascariasis, where the parasite affects the kidney, is an extremely rare clinical manifestation.
- Understanding unusual parasitic migration pathways is crucial for diagnosing and managing complex infections.
Observation:
- A 6-year-old boy presented with acute pyonephrosis (pus in the kidney).
- The patient passed adult Ascaris lumbricoides worms through the urethra prior to a nephrectomy.
- No intestinal-urinary tract fistula was identified, suggesting an alternative route of infection.
Findings:
- The clinical presentation suggests mature Ascaris lumbricoides worms gained direct entry into the renal system via the urethra.
- Worm obstruction of the right ureter led to hydronephrosis (swelling of the kidney due to urine backup) and pyonephrosis.
- Deposition of Ascaris ova within the renal tissue was observed, indicating parasitic presence and activity.
Implications:
- This case highlights the possibility of direct urethral entry of adult helminths into the urinary tract, challenging previous assumptions.
- It underscores the importance of considering parasitic infections in the differential diagnosis of pediatric renal pathologies, even in rare presentations.
- Further investigation into the mechanisms of aberrant parasite migration may inform prevention and treatment strategies for urogenital parasitic infections.