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Worm identification -Reply

Tue Nov 26 14:50:46 EST 1996


With out the corpus delicti it is a little difficult to diagnose but the red worm in the urine sounds like it might be
_Dioctophyma renale_.  From Brown and Neva 6th Ed. page 178:  "the kidney worm is found in Europe, North
America, and China.  The female is 20 to 100 cm by 5 to 12 mm and is a large, REDDISH nematode.  The males
are 14-40 cm X 4 to 6 mm.  Most often found in dog or mink, The eggs are passed in the urine, ingested by
annelids parasitic on crayfish.  Fish then acquire the organism by predation where the embryos molt to L4. 
Finally predation infects the mammals.  Mammals acquire the infection by consuming infected fish.  Infection of
humans is usually of the right kidney. less frequently in the abdominal cavity.  It destroys the kidney substance
and leaves an enlarged cystic shell containing the coiled worm and a purulent material.  If both kidneys become
infected, the host dies.  As of the this writing, there were 11 confirmed human cases and all involved the kidney
with symptoms including renal dysfunction or urethral obstruction.  The only treatment is the removal of the
infected organ.  Diagnosis is by finding the eggs in the urine.  The eggs are barrel shaped, brownish yellow
and measure 66 X 42 micrometers and have thick pitted shells.

Good luck and good luck to your patient.

Steve Kayes

Stephen G. Kayes, Ph.D                       Ofc: (334) 460-6768
Professor                                                FAX: (334) 460-6771
Structural and Cellular Biology; 2042 MSB
University of South Alabama College of Medicine
Mobile, AL  36688-0002             

E-mail: kayes at sungcg.usouthal.edu

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I had a call yesterday from a man who claims to have passed two large,  active worms in his urine stream.  He
described them as 10cm long and  2-3mm in diameter, red, with small hooks.  His doctor referred him to a 
urologist who sent the worm specimens to a public health lab.  An  identification was never made and,
unfortunately, the specimens are no  longer available.  Not surprisingly, the man who passed the worms is  still
anxious to find out what the worms may be.  Does anyone have any  ideas?  He has not done any recent
travelling and the only unusual food  he has eaten recently was some undercooked ground beef. A stool exam
is  planned and he has been asked to properly collect any further specimens.  Thank you,
Brent Dixon
Research Scientist
Health Canada

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