Abstract
Disseminated infection with Strongyloides stercoralis refers to the massive migration of infective larvae from the gastrointestinal tract to other organs that are not involved in the normal life cycle of the parasite. We describe the case of a Nigerian male with transitional cell carcinoma of the bladder in whom larvae of S. stercoralis was identified in the urine. This report involves a 60-year old male Nigerian presenting to the Urology clinic of the Jos University teaching hospital, Nigeria with disseminated S. stercoralis. The index patient presented with a 5 month history of total haematuria, urinary frequency, urgency, nocturia, straining to pass urine, feeling of incomplete voiding and terminal dribbling. He also had episodes of suprapubic pain. Physical examination revealed a cachexic patient who had mild suprapubic tenderness. Urinary examination showed numerous red blood cells and rhabditiform larvae of S. stercoralis. Abdominal ultrasound revealed a heterogeneous mass in the urinary bladder measuring 4.0 × 3.3 cm. Abdominal computed tomography also showed an irregular mass measuring 4.2 × 3.8 cm with HU of 41 projecting into the bladder from the posterior wall towards the dome. Histology of the biopsy specimen revealed transitional cell carcinoma. The patient was treated with a single dose of oral ivermectin but died 1 week later. Physicians working in areas that are endemic for S. stercoralis should consider investigating immunocompromised patients for S. stercoralis infection given the poor prognosis of disseminated infection in this group of patients.
This is a preview of subscription content, log in via an institution to check access.
References
Altintop L, Cakar B, Hokelek M et al (2010) Strongyloides stercoralis hyperinfection in a patient with rheumatoid arthritis and bronchial asthma: a case report. Ann Clin Microbiol Antimicrob 9:12
Azira NM, Zeehaida M (2010) Strongyloides stercoralis hyperinfection in a diabetic patient: case report. Trop Biomed 27(1):115–119
Brooker S, Bundy D (2009) Soil-transmitted Helminths. In: Cook G, Zumla A (eds) Manson’s tropical diseases, 22nd edn. WB Saunders, Philadelphia, PA, p 1532
Buonfrate D, Requena-Mendez A, Angheben A et al (2013) Severe strongyloidiasis: a systematic review of case reports. BMC Infect Dis 13:78
Fowler CF, Lindsay I, Lewin J et al (1982) Recurrent hyperinfestation with Strongyloides stercoralis in a renal allograft recipient. BMJ 285:1394
Gotuzzo E, Terashima A, Alvarez H et al (1999) Strongyloides stercoralis hyperinfection associated with human T cell lymphotropic virus type-1 infection in Peru. Am J Trop Med Hyg 60(1):146–149
Keiser PB, Nutman TB (2004) Strongyloides stercoralis in the immunocompromised population. Clin Microbiol Rev 17:208–217
Maguire J (2015) Intestinal Nematodes (Roundworms). In: Bennet J, Dolin R, Blaser M (eds) Mandell, Douglas, and Bennett’s principles and practice of infectious diseases, 8th edn. Elsevier Inc, Philadelphia, PA, pp 3204–3206
Mahmoud AAF (1996) Strongyloidiasis. Clin Infect Dis 23:949–953
Malakoutian T, Mohammadi R, Asgari M et al (2015) Disseminated strongyloidiasis in a patient with membranoproliferative glomerulonephritis—case report. Iran J Parasitol. 1:141–145
Morgan J, Schaffner W, Stone W (1986) Opportunistic strongyloidiasis in renal transplant recipients. Transplantation 42(5):518–524
Mori S, Konishi T, Matsuoka K et al (1998). Strongyloidiasis associated with nephrotic syndrome. http://www.ncbi.nlm.nih.gov/pubmed/9711888. Accessed 12 Sept 2018
Pasqualotto AC, Zborowski MF, dos Anjos M et al (2009) Strongyloides stercoralis in the urine. Trans R Soc Trop Med Hyg 103(1):106–107
Pocaterra L, Pérez G, Rojas E et al (2016) Urinary rhabditiform larvae of Strongyloides stercoralis in disseminated disease affecting a kidney-transplanted patient TT—Larvas rabditoides de Strongyloides stercoralis en orina en paciente conriñón trasplantado y estrongiloidiasis diseminada. Rev Medica Hered 27(1):35–40. http://www.scielo.org.pe/scielo.php?script=sci_arttext&pid=S1018-130X2016000100006&lang=es. Accessed 20 Sept 2018
Purvis RS, Ueichtler EL, Diven DC et al (1992) Strongyloides hyperinfection presenting with petechiae and purpura. Int J Dermatol. 31(3):169–171. https://dx.doi.org/10.1111/j.1365-4362.1992.tb03925.x. Accessed 27 Sept 2018
Puthiyakunnon S, Boddu S, Li Y et al (2014) Strongyloidiasis—an insight into its global prevalence and management. PLoS Negl Trop Dis 8(8):e3018
Roxby AC, Gottlieb GS, Limaye AP (2009) Immunocompromised hosts: Strongyloidiasis in transplant patients. Clin Infect Dis 49(9):1411–1423. http://dx.doi.org/10.1086/630201. Accessed 19 Sept 2018
Safdar A, Malathum K, Rodriguez SJ et al (2014) Strongyloidiasis in patients at a comprehensive cancer center in the United States: a retrospective study covering the years 1971–2003. Cancer 100(7):1531–1536
Stewart DM, Ramanathan R, Mahanty S et al (2011) Disseminated Strongyloides stercoralis infection in HTLV-1-associated adult T-cell leukemia/lymphoma. Acta Haematol 126(2):63–67
Whitehill R, Miller MH (1944) Infestation of the genito-urinary tract by Strongyloides stercoralis: a case report. Bull Johns Hopkins Hosp 75(3):169–174
Author information
Authors and Affiliations
Contributions
IOI conceived the case report; ICA was directly involved in treating the patient; IOI and KIO ran the laboratory tests; IOI, AAO and ICA made the first draft; all authors read and edited the first draft for intellectual content.
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflict of interest.
Informed consent
Informed consent was obtained from the next of kin of this patient to proceed with this report.
Rights and permissions
About this article
Cite this article
Ita, O.I., Akpayak, I.C., Onyedibe, K.I. et al. Strongyloides stercoralis larvae in the urine of a patient with transitional cell carcinoma of the bladder: a case report. J Parasit Dis 43, 154–157 (2019). https://doi.org/10.1007/s12639-018-1051-6
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12639-018-1051-6